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Identifi: Value-Based Technology Platform

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Identifi enables care teams, physicians and administrators to operate in a connected fashion, working from a single view of the patient. A fully integrated platform, interoperable with your EMR, and supported by clinical and technical experts, Identifi is proven to drive clinical and financial return.

Identifi is different because it was built to operate within the most challenging value-based environments. It combines population health technology proven to maximize impact with
EMR-centric physician engagement, built-in operational expertise to mitigate execution risk and configurability to quickly meet the changing needs of your value business.

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Identifi: Value-Based Technology Platform

  1. 1. VALUE-BASED TECHNOLOGY PLATFORM
  2. 2. CONNECTED CARE An Identifi-powered patient story Meet Sue Sue is 47 years old and suffers from diabetes. She lives two bus lines away from her endocrinologist and struggles with her medications. She visits the ED regularly for hyperglycemia and has little family support. Identifi’s advanced data aggregation, clinical profiling and predictive models find social and environmental factors that, despite a clinical risk of ‘moderate’, make her a candidate for complex care. Identifi’s clinical profiling recognized higher quality and lower cost interventions that will have greater impact on Sue’s health. This intelligence is automatically shared with her newly assigned Care Manager, Laura, who calls Sue, reviews her history, builds her care plan and arranges a PCP visit. Sue feels re-energized and supported to tackle her health. Meet Sue’s PCP Dr. Cooper is an Internist who sees up to 30 patients a day and is struggling to keep up with increasing revenue pressures. She finds much of her patient visit time is spent uncovering information that may have already been discovered by the patient’s care team. Today was different. Dr. Cooper’s EMR notified her through a banner powered by Identifi that Sue is high risk, enrolled in a complex care program, and provided her with information on Sue’s engagement success, problems and goals, and her Care Manager’s contact information. Dr. Cooper recognizes Sue’s transportation issues, and refers Sue to an in-network Endocrinologist in her neighborhood. Dr. Cooper orders a maintenance panel, performs a foot exam, discusses Sue’s treatment goals, and speaks with Sue’s Care Manager, Laura, to update the care plan. Meet Sue’s Endocrinologist Dr. Ahmed is an affiliated specialist with a different EMR than Dr. Cooper. He doesn’t know who has provided care, or what issues may inhibit his patients’ treatment adherence. With Identifi Practice, Dr. Ahmed can see the care plan updated by Laura and Dr. Cooper, and he is notified of Sue’s remaining gaps in care. Laura shared that Sue has been referred to a social worker to assist with her transportation issues, and Dr. Ahmed sees results from Dr. Cooper’s exams. In Identifi Practice, Dr. Ahmed notes a gap of care for Sue. He places the order for her urine microalbumin and lets Dr. Cooper know that he has addressed this care gap. Dr. Ahmed discusses the new insulin prescriptions with Sue, and calls Laura to confirm Sue will receive support for continued medication adherence. RESULTS We all want to improve quality, transparency, and provide a better patient experience. Identifi provides information to impact the cost of care and remove connectivity barriers to truly integrated care. QUALITY • Placement in the right care program • Care gaps closed (a1c tests, foot exam, microalbumin, retinal exam, blood pressure check) • Improved medication adherence PATIENT SATISFACTION • Understands care plan • Receives necessary support • Feels healthier, empowered and engaged in care COST OF CARE • Frequent ED visits eliminated • Lower risk of hospital admission • Increased quality scores • Reduced inappropriate utilization
  3. 3. MEET IDENTIFI Identifi enables care teams, physicians and administrators to operate in a connected fashion, working from a single view of the patient. A fully integrated platform, interoperable with your EMR, and supported by clinical and technical experts, Identifi is proven to drive clinical and financial return. STRATIFICATION & ANALYTICS Localizable stratification logic connecting predictive models with user workflow and analytics EMR OPTIMIZATION Integrates Identifi generated insights, clinical and business intelligence and workflow directly into the host EMR IDENTIFI RAF NLP enabled RAF workflow driving optimal documentation and HCC-coding IDENTIFI PRACTICE Value business workflow and analytics for practices outside the host EMR IDENTIFI CARE Configurable care management workflow platform to coordinate clinical work across care teams IDENTIFI UM UM workflow and analytics with integrated medical policy decision support IDENTIFI ANALYTICS Customizable analytics and reporting tools to surface insights across the entire Identifi solution DATA WAREHOUSE DATA INTEGRATION SERVICES Data collection and management services and a patient-centric Data Warehouse • Workflow Generated Data • Clinical Data • Self-Reported Data • Financial and Admin Data • Socio-Economic Data • EMR Data RULES A highly configurable rules engine that applies Evolent’s clinical and business intelligence insights to each patient record enabling workflow and analytics, supported by a team of clinical informaticists
  4. 4. VALUE-BASED TECHNOLOGY PLATFORM Identifi is different because it was built to operate within the most challenging value-based environments. It combines population health technology proven to maximize impact with EMR-centric physician engagement, built-in operational expertise to mitigate execution risk and configurability to quickly meet the changing needs of your value business: Maximize Impact You need a technology platform that has been road-tested and proven by operators like you to consistently drive market- leading clinical and financial impact. • Single enterprise data “source of truth” • High-risk and impact-able patients assigned to right clinical programs • Continuous clinical profiling focuses care team on highest ROI patients and interventions • Transition and ER utilization programs triggered by real time intervention engine • Reduces utilization while elevating quality • Care gaps and RAF coding opportunities surfaced within workflow • EMR interoperability optimizes EMR investment Engage Physicians in Value There is no “one size fits all” approach to engaging physicians. Your technology platform must interoperate with EMRs, connect your affiliate practices and flex to match physician workflow. • Accurate, trustworthy clinical profiling through context-sensitive CCD aggregation • Statistically proven and clinically specific predictive models enhance physician trust of data • Multi-source data provides employed and affiliate physicians with a 360° view of their patients • Supports real-time, cross-functional collaboration across the extended care team within existing workflow • Provides full visibility into performance against cost and quality metrics Downsize Execution Risk Mitigate human error across the value continuum through advanced workflow automation, cross-team communication and rigorous performance management. • Proven ability to integrate disparate data sources in a cost-effective way • Dedicated support from data experts, clinical informaticists and analysts reduces TCO • Contract specific configuration ensures consistent execution against the right activities for each managed population • NCQA-compliant clinical program workflow • Evidence based workflow design reduces variability • Platform design enables proven approach to performance management Embrace Increased Complexity Change is certain. Your technology must adapt and scale quickly without the need to rip and replace or hire new operations support staff. • Highly flexible to manage increased complexity from population specific data, workflow and measurement needs • Rules and measures updated in weeks rather than months • Proven clinical program and population specific predictive models • Prioritized clinical action items configurable by population • Configurable SLA requirements by line of business • Constantly expanding library of existing reports and highly flexible self-serve analytics
  5. 5. OUR MISSION Evolent Health intends to be the market leader in value-based health care by continuing to build its national network of leading health systems that benefit from shared infrastructure and innovation as they lead the shift from volume-based to value-based care. Health systems require a partner that can drive lasting change through the right infrastructure, insights, processes and people, with the technology and analytics to guide care choices and coordination. Evolent’s provider-led solution breaks down barriers, aligns incentives and creates a new approach to care delivery oriented around meaningful engagement between providers, payers, physicians and patients. To promote value-based care and ultimately, healthier communities, the Evolent Health platform embeds and connects crucial capabilities across the health system enterprise: • At the heart of the strategy, Evolent engages and aligns with physicians in leading and designing the new model of value-based care, a model that allows them the flexibility to practice medicine the way they always wanted. • Evolent works with physicians and health systems to enable population health management by outfitting care teams with the information and platform needed to stratify populations and to better target and tailor interventions. • Evolent provides payer-neutral risk and financial support to help systems evolve and enhance existing payer relationships or to launch provider- owned plans, securing alignment between the delivery of care and its mechanism of payment. Established in 2011 by a group of experts from every corner of health care who want to drive widespread value-based care adoption, helping health care providers, physicians and patients achieve successful and sustainable outcomes. Over 850-member team rapidly growing across Arlington, Virginia headquarters, and other locations in San Francisco, California; Pittsburgh, Pennsylvania; Atlanta, Georgia; Indianapolis, Indiana and client markets. Founding partners offer significant intellectual property contributions and market proven approaches in support of value-based care objectives: UPMC Health Plan—the nation’s second largest provider-owned health plan with 1.8 million members, and The Advisory Board Company—a global research, technology and consulting firm partnering with 150,000 leaders across health care and higher education. Leading health system partners in over 25 U.S. markets. Clients include MedStar Health, Indiana University Health, Premier Health and WakeMed Health & Hospitals. To change the health of the nation by changing the way health care is delivered.
  6. 6. 800 N. Glebe Road, Suite 500 Arlington, VA 22203 571.389.6000 info@evolenthealth.com

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