Effective population health management requires tools that enable widespread collaboration to orchestrate care among multiple providers and diverse care settings to achieve a common goal: optimizing how care is delivered to ensure that each patient or member receives the right care at the right time from the right provider. This means identifying complex or higher risk patients and members who can benefit from more intensive care coordination, and addressing not only their medical issues, but also the behavioral and social determinants that affect patient health.
Our technology platform, called GSIHealthCoordinator, is built specifically for care coordination, uniting care teams that include providers, health systems, community organizations, and payers of all kinds to help you deliver collaborative, whole-person care within complex populations. Every day, we help providers transform the way they deliver whole-person care, empowering caregivers to identify the services and care of each patient and facilitate access to the providers, services, and resources the patient needs the most.
We believe that combining care coordination with powerful analytics in a single platform creates the synergies and insights that enable real population health management success. Our GSIHealthCoordinator platform integrates and analyzes data from across the community—including medical, behavioral and social information—to provide a more complete picture with better understanding of the needs and overall health of individual patients and entire populations. This innovative approach consolidates diverse and fragmented data in a single comprehensive care plan, with meaningful insights that enable care teams to proactively address gaps in patient care, allocate scarce resources, and strategically identify at-risk patients in time for cost-effective interventions. The result is improved clinical outcomes, more effective care teams, better financial results, and ultimately healthier populations.
Learn more about GSI Health’s approach to:
Chilmark: GSI Health’s care plans incorporate elements of behavioral health and SDoH and are highly configurable based on an organization’s care management model and care activity workflow across multiple settings.
Chilmark Care Management Market Trends Report
74% of patients attend PCP appointment within 90 days of discharge. Learn more.
CBC Pathway Home: Care Transitions Intervention Program
“Analysis enables us see where we are, and have an understanding of how we do what we do and why. The analysis evaluates the trends and helps us figure out whether we’re doing the job right and whether we need to change.”
Kevin Beckman, Director of Health Home Operations, Home Health Partners of Western New York
“We were able to leverage the technology to help us find our patients, evaluate acuity, prioritize, and coordinate actions, even when all other services were down.”
Kathleen Donaldson, Director of IT Home- and Community-Based Care, Health Home Partners of Western NY
“GSI Health’s client support is incredible—we can send a request and they respond immediately. Sometimes they have answers even before we’re ready to receive them.”
Vicki Landes, Director, Health Home for Niagara Falls Memorial Medical Center
Care coordination and care management — Access and share information in real-time, build and leverage universal care plans, and enable interdisciplinary care teams to effectively collaborate on patient care.
Insights — Aggregate and analyze information from disparate organizations to assess and stratify populations, close care gaps, identify cost-effective interventions, and make your care teams more effective.
Measurement — Accurate, timely reporting on performance, care quality, and outcomes so you can enhance processes, allocate resources, and improve outcomes and financial results.
Interoperability — A single platform that enables data transparency across your network to provide care teams with critical information and insights at the point of care and measurement for oversight from a variety of external data sources.