Our Solutions

Procedural Proficiency Management (Site of Service selection)

Enable is an in-practice clinical solution that intelligently determines care pathways for orthopaedic patients.  The platform generates industry validated risk scores to determine the appropriate site of service (In-patient, Out-patient hospital, ASC) for each individual patient.

This easy to use online tool, delivers an integrated Clinical Pathway Score™ for each individual patient, in real time, to help patients and their doctors to achieve the desired health outcomes.

Our Solution provides the facility with the ability to compare clinical and process outcomes to ensure revenue is optimized. This helps all stakeholders participating in risk-based arrangements to improve quality outcomes.

 

The Orthopaedic Application includes the following:

  • Quantitative assessment of patient clinical risk.
    • This allows providers to control for negative revenue events by defining risk and steering patients to an appropriate site of service.
  • The proprietary Clinical Pathway Score™ is used as a Joint replacement site of service indicator, to:
    • Manage Patient Clinical Risk
    • Create value for ALL stakeholders (Patient, Provider, Payor)
  • This is a Provider based digital technology platform allowing for:
    • Provider Clinical profiling
    • Patient Profiling
    • Clinical Management Dashboards
    • Outlier identification and management
    • Behavioural trend identification and management

Ensuring optimal risk management via appropriate clinical decision making.

Please contact us to setup a meeting or a demonstration.

Automated Clinical/Internal Pre-Authorization

Our configurable stack of Decision Intelligence Engines is at the heart of the Digital Health Ecosystem that we use to optimize clinical decision making.

We offer Healthcare solutions that are built modularly in order to offer clients specific solutions for Healthcare problems, without replacing their complete existing system. This modular approach allows for flexibility and faster implementation time.

The clinical modules can be seamlessly integrated into the existing workflow of a Healthcare Provider practice, to ensure transparent, consistent and accurate application of clinical rules, and cross match validations.

Configurable algorithms identify specialized or high risk scenarios, for review in a real-time, on demand basis.

The following principles are applied:

  • Clinical appropriateness and best practice standards
    • Dynamic patient specific rule application, to ensure objective clinical decision making based on the provider approved clinical rules
    • Minimizing potential Medico-legal exposure
  • Clinical coding intelligence
    • These include diagnosis code to diagnosis code validations.
    • Diagnosis to procedure code validation.  
  • Fully Integrated offering with Site-of-service selection (As an integrated, or stand-alone solution)

Please contact us to setup a meeting or a demonstration.