Population Dimensions

PR

OD

UC

T B

RIE

F |

Clin

ical

Sol

uti

ons

Generate a single context of care that is shared by payers and providers and enable timely population insight across healthcare partnerships and communities

PB

“The greatest value of a picture is when it forces us to notice what we never expected to see.” John Tukey

2

The transition from fee-for-service to pay-for-value is driving clinical strategies and innovation portfolios of payers and providers across the US. With value-based models projected to cover 35% of their member populations, payers and providers are scaling ACO, IDN and PCMH partnerships to leapfrog the limitations of early PHM programs. To retain and expand competitive positions in this new environment, payers need to provide infrastructure and expertise to enable their partners’ success in the next generation of value-based programs.

Payers are designing value-based contracts to capture savings from population health iniatives and are automating contract administration to control administrative costs and enable end-to-end transparency. Payers need to assimilate clinical information from providers to understand and appreciate risk, outcome and quality trends.

Providers are facing challenges in modeling the impact of taking on risk and predicting their hypothetical performance under VBR programs, as well as measuring performance during the program. Providers also need the ability to scale across multiple payers and view practitioner performance holistically.

Transform integrated data sets to just-in-time insights about patients and populations across institutional boundaries, spanning multi-stakeholder communities.

Transform integrated data sets to just-in-time insights

3

MSSP program to grow to 7.2M lives in 2015

Experimenting one form of VBR. Large variation in

methodologies

PAYERS 75%

New ACOs in 2014

742ACOs

Increasing downside risk >50% of VBR contracts in

the next 36 months will have downside risk

50VBRPrograms

%

Trusted and established electronic data exchange partnered with superior data exchange building blocks, we have edge of the enterprise infrastructure already in place to manage and troubleshoot transaction data

Single solution for administrative, clinical, and financial data translates to lower operating costs for secure data sharing between payers and providers

Disruptive implementations avoided, enabling a low cost experimental model for emerging healthcare partnerships

Greater member-level insights via combined administrative, clinical and financial data—enabling the creation of a truly comprehensive member longitudinal record

Building on our history of EDI leadership success, Edifecs facilitates new collaborative data sharing of clinical information among healthcare organizations.

Population Dimensions streamlines payer-provider collaboration by providing a framework for the aggregation of clinical, financial and administrative data, as well as workflow tools that provide timely population insight and risk markers to virtual care managers and care coordinators.

With near real-time data exchange, Population Dimensions enables all healthcare stakeholders to act on the data when and where they need, leading to meaningful collaboration.

Why count onour expertise?

4

Population Dimensions assembles integrated patient records with aggregated data. The shared patient view is supplemented with workflow capabilities that enable seamless coordination of care for patients. Gaps in care, risk scores and other insights that payer systems typically generate for patients are integrated into the shared view of the patient. Powerful, uncluttered data visualization leads to deeper patient and population insights.

Edge technology substantially reduces time lag in the communication of discovered insights to physicians caring for the patient. This additional information from the payer, allows the care team to prioritize patients based on clinical risks or conditions. Administrative and value-based partner network coverage information is proactively used to steer transitions of care, preserving value-based network integrity.

EdifecsPopulationDimensions

5

Population Dimensions is built on Edifecs Partnership Platform that is scalable to support exponential growth of digital data in healthcare. The platform is designed to leverage existing investments through the use of sophisticated data virtualization capabilities to seamlessly integrate remote data sources into the Integrated Patient Record. Population Dimensions offers a number of options to view or access member information, including portal-based access using the Population Dimensions portal, and remote access using Data as a Service (DaaS).

EdifecsPartnership Platform

Data Sources

Data Categories

PopulationDimensions

Data Preprocessing

Integrated Patient Record

Real-time Intervention Gateway

Medical Encounters Services

Lifestyle

Terminology Mapping

hDaaS

HL7

FHIR

InterventionKnowledge

EMPI | Normalization | De-Duplication

ProviderPayer

Hospital

6

Population Dimensions delivers insights and discoveries from trended clinical values for patients along with concurrent risk scores and network usage information.

Unclutteredby design

7

Modern Infrastructureto scale populationhealth managementpartnerships

Integrated patientrecord (IPR)

Centralized clinicalrepository

Access options

Population Dimensions addresses the need of organizations to scale population health initiatives solutions that were used in early pilots.

The medical history information in the integrated patient view combines clinical information in real-time, as they are received from disparate provider sources with the clinical context of a patient’s claims sourced from the health plan.

The real-time update to an integrated patient view is made possible by edge of the enterprise-based infrastructure that extracts clinical information from inbound data streams.

Population Dimensions offers a number of options to view or access member / patient information, including portal-based access using the Population Dimensions portal.

Population Dimensions provides a comprehensive repository of integrated information about the patient and the value-based partner network in a single shared view. Administrative and value- based partner network coverage information is proactively used to steer transitions of care, preserving value-based network integrity.

The patient view can be updated within two hours of an ADT event. The IPR is enhanced to reduce clutter and normalize vocabulary across data sources.

Inbound, transactions “in motion” are normalized and correlated with patient context and stored in a patient-centric repository.

Remote access is conveniently delivered to clinicians via Data as a Service (DaaS) to enhance clinical workflow.

Population Dimensions capabilities

8

Scale Partnerships Increase transparency between payers and their value-based partners by collecting and providing visibility into the complete care value chain.

Support exponential growth of digital data in healthcare with the virtualized Edifecs Partnership Platform.

Reduce the time lag involved in communicating patient health status to care team with a single patient view updated in real-time.

Streamline care coordination and track closure of interventions and care gaps with an integrated workflow process.

Shared patient view incorporates comprehensive Population Health Management data set including clinical, financial, and administrative data.

Operationalize early health risk detection and prevent exacerbation of existing health conditions.

Lower costs by reducing potentially redundant services through real-time insights into integrated member records.

Automate distribution of clinical and quality data to support faster claims processing and replace manual administrative efforts.

Improve Care Coordination

Improve Care Transitions

Reduce Costs

Benefits and supporting features

9

Founded 1996

Headquarters Bellevue, WA Global Offices Gurgaon, IndiaMohali, IndiaAmsterdam, Netherlands

Total Customers 1200+

Total Healthcare Customers 350+

Compound Growth Rate 28.2% (2009-2014)

Cumulative Growth Rate 249% (2009-2014)

Funding Employee-owned, No debt, Profitable Worldwide Associates 700+

Edifecs at aglance

Learn more about our offerings.

visit Edifecs Clinical Solutions

For sales inquiries Contact

Court Troy425-435-2200courtney.troy@edifecs.com