Digital Empowerment of Care and Self Management.

Socio-Behavioral & AI Powered Value Based Care with apt Patient Engagement

Our Approach

DEFINE AN INDIVIDUAL

Aggregate both historical and real-time health data to dynamically define an individual using machine learning and deep learning algorithms.

CARE WITH COMPASSION

Let the machine augment caregivers to proactively take care of patients enabling caregivers to do what they do best: Care with compassion.

PATIENT ENGAGEMENT

Build trust between patients and care managers by allowing them to review live health data and while providing a platform for full transparency.

Capability

Empower patients and caregivers with the power of AI

healthlligence provides a holistic view of individuals starting with social, behavioral, and clinical needs. The key to Patient Engagement is having real time data, while understanding the social environment and well-being of these patients. This enables practitioners to execute best practices and enhance the patient experience.

Precision Medicine

Precision medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person

Precision medicine approach leverages a patient’s

  • Genetic history
  • Location
  • Environmental factors
  • Lifestyle and habits
  • Clinical Data
  • To determine a plan of action for treatment
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Remote Patient Monitoring

We empower patients to receive care while at home simultaneously providing the required insights and alerts to providers and care managers. We provide real time analytics on data points received from any remote device or sensor to generate alerts taking into account the patient as a whole. Powerful communication tools such as “Telemedicine” and “Direct Messaging” encourages direct contact between the patient and caregiver when alerted. Patients can also educate themselves based on these data points and take actions using the healthwallet.me app. Chronic conditions that we manage:

  • Heart Disease: Blood Pressure, heart rate, EKG readings, Cholestrol, BMI
  • Hypertension: Blood Pressure, heart rate, Stages of sleep
  • Diabetes and pre-diabetes: Glucose, BMI
  • COPD: Pulse Oximetry
  • Kidney Disease: GFR
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Care Management

Our Care Management begins with Assessments, Data Collection (SDoH, Clinical, Adminstrative, Real-time) and calculating Risk Scores using our health3d.ai platform. Our AI process then generates care plans by interpreting all the data (structured and un-structured), finding patterns and establishing problems with goals and barriers to acheive those goals.

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Actions are generated for patients, while tasks are generated for care managers. These actions help maximize the level of automation. Our AI engine, health3d.ai closes any gap in care and helps towards gaining better clinical outcomes and reducing per capita cost. Moreover care coordination, transition care management and discharge planning is accessed in real time with adoption of our healthwallet.me app. The healthwallet.me app engages patients with direct messaging, remote teleconferencing, remote patient monitoring tools and real-time analytics. Enabling these automated processes has a direct correlation with reduced utilization. All costs are considered before implementing the system, thereby making sure the ROI is achieved.

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Cancer Care Management

Measure the risk score of cancer for each patient
Predict the survival rate of each patient
Compare the survival rate of different groups of patients

  • Different Treatments
  • Different Profiles
  • Different Clinical Factors
  • Different Gene Expressions
  • Kaplan-Meier
  • Cox Regression
  • Event, and Time, and Qualitative Features
  • Event and Time, and Clinical Factors
  • Event and Time, and Gene Expression
  • Survival Risk rate
  • Survival Prediction
  • Hazard Ratio
  • Hazard Prediction
  • Patient Stratification
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Population Health Management

Quality, Prevention, and effective care management are key elements to deliver patient centric care to the most complex patients while keeping them at home and out of the hospital. To effectively manage your entire population, not only is keeping track of every single patient important, but to keep them healthy through continuous monitoring, identifying and resolving gaps in care, effective predictive and stratification tools which assist in cost reduction. Four key elements that enable PHM that we cover:

  • Socio-Economic, Behavioral, Clinical and Administrative Assessments
  • Risk Scoring
    • SBVI (Socio Behavioral Vulnerability Index)
    • CMS HCC
    • HHS HCC
    • CCI (Charlson Comorbidity Index)
    • CCC (Chronic Comorbidity Count)
    • LACE HRA Index (Risk of Readmission)
  • Health Analytics and Visualization Dashboards
  • Quickly access Patient Population, Population Tiering and Registries with the Reporting features of the pop360 Dashboard.
  • FHIR enabled data extracts from EHR
  • FHIR enabled Patient API's
  • AI based care plan generation
  • Chronic care management
  • Care coordination
  • Transitional care management
  • Assessments
  • healthwallet.me provides a 360 degree view of a patient's health
  • Timeline of health
  • RPM dashboards
  • Telemedicine
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Patient Engagement

Empowering patients is a key element when it comes to patient outcomes, allowing them ownership of their own health is essential in keeping them engaged and in control. We have developed tools that support all of their social, behavioral, and medical needs in real time, therefore empowering them to make decisions along with their practitioners.
We engage them by:

  • Providing a health360 view
  • Timeline of their health
  • Take assessments
  • RPM dashboards and insights
  • Telemedicine
  • Care team management and communication
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Telemedicine

With Remote Patient Monitoring, Telemedicine becomes imperative for checking in on patients on a regular basis. Our mission is to provide care managers with technology that allows them to spend more time with patients and the care team. Telemedicine promotes a symbiotic relationship between the care manager and the patient. Providing insights to the care manager helps them empathize with their patients needs – both social and clinical. Multi-chat video conferencing and messaging allows the Integrated Care Team on a video/audio call to have group communication. Privacy and security are of utmost importance to us as we follow HIPPA Compliancy.

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Value Based Care

Improve both clinical and financial outcomes for patient and population health management using our health3D.ai platform. We strive to reduce the impact of chronic disease by proactively generating actions for the preventive care management team, care coordination team and the patient.

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Our careassistant.ai platform will generate care plans and actions to allow Care managers to better manage their patients. health3d.ai converts EMR notes, care team notes and assessments into identifying gaps in care and formalizes a plan to overcome them and to set goals. Moreover, proactive monitoring of patients is possible through RPM and Telemedicine. Our model helps patients recover from illness and injuries more efficiently, thereby decreasing chances of developing chronic disease.

As we integrate data from various remote sources giving a holistic patient centered approach, we get to an integrated model for care, respective to primary, acute and speciality care; managed by a care team. Improvements in outcomes are measured over time, which are evident in our Patient Timeline or pop360 dashboard for the entire patient population. These outcomes could be hospital readmissions, adverse events, patient engagement and overall population health and adherence.

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Data Aggregation

Most modern EMR platforms (Cerner, EPIC, OpenMRS etc) support FHIR/HL7 based API out of the box. While health3D.ai can do traditional file exchange and ETL/ELT based data loading, it has support for FHIR based APIs and traditional ETL based on HL7/FHIR format. We fully understand businesses evolve quickly, in turn data ingestion techniques should be flexible for customer needs. We designed health3D.ai to support Streaming ETL (aka real time ETL) to support real-time integration which helps in keeping longitudinal patient record and other critical patient data and transactions up to date and enhances the accuracy of analytics driven from the Data warehouse.

  • Medical claims
  • Pharmacy claims
  • Lab
  • Social determinants
  • Assessments
  • Genomic
  • Sensors
  • EMR/EHR data/case notes
  • Social media
  • Allergies
  • Vitals
  • Fitness/Medical devices
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CMS Final Rule: Interoperability

The CMS Interoperability and Patient Access Final Rule will enable interoperability of clinical and administrative data thereby patients having access and sharing their data with providers or other apps as required. The CMS 9115-F compliance mandates for payers to have Patient Access API’s and Provider Directory API’s by July 1st 2021 and Payer-to-payer data exchange by Jan 1st 2022. Follwed by Federal-state data exchange by April 1st 2022.

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HL7/FHIR is the future of healthcare data exchange, and it is a fundamental move away from a document-centric approach to a data-level access approach using application programming interfaces or API. health3D.ai is built on API principles and fully FHIR compliant and it interfaces with all components (internal & external) via REST based services. It supports canonical standards such as FHIR, HL7 out of the box and can be interfaced with all REST compliant services. APIs provide seamless integration possibilities to enhance features of customer applications. health3D has support for 275 FHIR resources and is customizable to accept on need basis resources. health3D.ai enables existing healthcare systems as FHIR compliant to exchange member/patient data according to CMS rules.

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About Us

Technology that focuses on enhanced outcomes and better experiences

At healthlligence our mission is to empower both caregivers and individuals with the right AI powered tools that will drive the wellbeing and ownership for individuals and augment caregivers to take the right action proactively.