Care Management

Care Coordination & Engagement

Caradigm solutions enable care team collaboration and increased patient adherence that drive improved outcomes for patient populations.

 

A foundational strategy for healthcare organizations seeking to expand their population health management initiatives, is scaling care management across their organizations.

Care management requires the coordination of a diverse group of clinicians, often working with incomplete patient information and inefficient manual workflows. Caradigm Care Management is an enterprise solution designed to improve coordination of your multidisciplinary teams, across the continuum of care. Care Management helps healthcare organizations manage large patient populations by integrating evidence-based clinical guidelines into patient-centric care plans and recommend mitigations, and helps care managers plan their day and daily priorities. This helps you improve patient outcomes and care efficiency for high-risk patient populations.

 

Caradigm Care Management supports several value-based initiatives including shared savings programs and bundled payments by helping to manage the clinical and financial risk within their assigned population of beneficiaries.

To help promote patient adherence to mediation and treatment plans Caradigm Care Management utilizes the Patient Activation Measure (PAM)® self-management survey. By using this integrated solution, customers will be better able to:

  •    Accurately and quickly predict individuals at risk for adverse health outcomes, chronic conditions and costly    utilization
  •    Reduce healthcare costs
  •    Improve patient care quality, health behaviors and outcomes
  •    Bolster patient satisfaction and retention
  •    Increase operational efficiencies
  •    Achieve quality and performance metrics (e.g., STAR ratings, CAHPS scores, URAC and NCQA standards, HEDIS    measures, MACRA/MIPS requirements)

Patient data is surfaced through a care management dashboard, that quickly shows you views of your population data and drill downs into specific patient data.

Content Builder

To help enable business analysts and clinical analysts to manage their own content creation and updates, Caradigm Care Management offers an optional Content Builder tool.

Content Builder enables care managers to define Problems, Goals and Interventions (PGIs), as well adapt tasks, workflows, and programs used in Care Management to meet your specific needs. It also allows quick removal or addition of programs and related assessments that were originally created using the Content Builder tool.

Social Determinants of Health

Caradigm Care Management makes social determinant information (food access, transportation access, home stability, financial stability and health literacy) readily available to the care team of patients that are enrolled in a care management program. The display of social determinants helps present a comprehensive picture of a patient’s health to the care team. Further, if the patient has medium to high risk social determinant factors, when enrolled into a program, the plan of care is pre-populated with interventions to address those factors.

Social determinants of health account for approximately 50 percent of overall patient health and include education, job status, social support, income and community safety. Patients that have socioeconomic or environmental challenges are less likely to have the ability to cope when physical health issues arise. Therefore, having insight into the social determinant factors impacting a patient population can help healthcare organizations better identify patients at-risk and assist in dealing with these issues that can have an extraordinary impact on cost, quality and adherence to the plan of care.

 

How it works

 

 

Key Features

  •    Comprehensive, extensible assessments
  •    Personalized, data-driven and dynamic plans of care
  •    Evidence-based workflows
  •    Content Builder tool to develop custom assessments
  •    User-defined, prioritized care management dashboard
  •    Role-based tasking to enable top-of-license work
  •    Streamlined medication review
  •    Automated, event-based tasking
  •    Tracking and reporting of time spent per month
  •    Flagging and following of bundled-payment candidates

 

Key Benefits

  •    Improve coordination of care among disparate providers
  •    View comprehensive, cross-community patient data
  •    Enable clinicians across the healthcare community to provide proactive intervention
  •    Increase patient engagement
  •    Enhance clinical and financial outcomes
  •    Help organizations more predictably manage cost and risk
  •    Measure performance of teams and individuals
  •    Support Medicare CCM program
  •    Support bundled-payment programs