Care Coordination Software

CCS centralizes patient data (e.g., demographics, medical history, medications, lab and image study results, social determinants of health) and provides secure access to it for all involved parties. If there are any updates (e.g., a new treatment plan is created or new test results arrive), the system can send automatic alerts to all the involved caregivers.

Care plans provide a real-time view of where each patient stands in their treatment journey and are available to various care specialists according to their roles. The system can also enable transition plan management, monitoring of patient deviations from the care plan, and tracking of longitudinal patient progress. Direct messaging and calls between care professionals can be enabled.

CCS can serve as a central repository of all patient-related documents, including treatment plans, test reports, consent forms, and communication logs. It arranges documents in folders, has version control features, and allows for keyword- and tag-based search. Users can leave comments, collaborate on files in real time, and attach them to certain tasks. Such solutions can also have e-signature functionality to ensure the secure signing of medical documents (e.g., consent forms, prescriptions).

CCS allows care coordinators to assign tasks based on team member availability and qualifications, set priority levels and deadlines, and track care delivery progress. The system can send reminders on upcoming deadlines, categorize tasks by type (e.g., administrative, clinical) and patient needs (e.g., chronic disease management, mental health), and group task lists by due date and priority.

CCS provides a convenient catalog of referral partners and customizable templates for creating referrals. It can also automatically direct referrals to the relevant parties and notify them about it. Users can track each referral status in real time and get updates in the form of appointment confirmations and results from specialists. In-network and often-referred partners can be added to the "favorites" list.

CCS can exchange data with various systems using data exchange protocols (e.g., HL7, FHIR) and imaging standards like DICOM. For instance, it can automatically import medical history data from EHR/EMR, send test and image study orders to LIMS/LIS and RIS, and get alerts on patient vitals from a remote patient monitoring system. When integrated with a telehealth platform, such solutions allow healthcare specialists to conduct virtual visits via video or audio calls.

CCS allows a healthcare organization's staff to schedule appointments, send automated appointment reminders to patients, and manage waitlists (e.g., notify patients about newly available time slots). The system can detect schedule conflicts and flag periods of low activity to help optimize scheduling. The appointment calendar may also show data on resource availability and overall facility capacity, which helps to prevent overscheduling.

CCS solutions provide a 360-degree view of internal and cross-site resources, including staff, physical spaces, equipment, and medical supplies. Depending on the use case, such solutions can provide tools for inventory reordering and shortage alerting, equipment maintenance scheduling, supply chain management, predictive maintenance, and more.

With accompanying patient portals and mobile apps, CCS lets patients access their health and appointment information, initiate appointments, ask physicians questions, get reminders on medication intake, fill out pre-visit forms, and more. Patients can also leave their feedback, e.g., through satisfaction surveys or feedback forms.

CCS with reporting and analytics features enables organizations to track financial, operational, care management, and other metrics (e.g., visit utilization rates, operating cash flow), segment patients (e.g., by demographics, chronic conditions), and send automated reports to the relevant parties. Advanced solutions can be used to predict future trends (e.g., health outcomes, complications, patients at risk of high-cost events) and get real-time alerts (e.g., on critical events).

CCS provides access to patients' medication histories (e.g., previous prescriptions, dosages, adverse events). It may feature tools for creating and modifying electronic prescriptions and send alerts on potential drug interactions. Patients can get reminders about planned medication intake or upcoming home or in-office visits for administering medication. CCS can also be integrated with pharmacy systems, for instance, to send e-prescriptions to pharmacies or to track medication adherence when drugs are administered at the pharmacy.

To ensure data protection in line with HIPAA, GDPR, and other regulations, CCS includes a set of data protection mechanisms, including role-based user access, multi-factor authentication, data encryption at rest and in transit, and data anonymization. Such solutions can also have audit trails to maintain logs of all actions and changes and thus ensure complete traceability and accountability.

Providing access to comprehensive patient data from medical history to social factors and giving a 360-degree view of patient interactions with the healthcare system, CCS allows healthcare providers to develop a systematic approach to improving health outcomes for different patient groups, including patients with chronic diseases, geriatric population, and low-income groups. CCS can help identify high-risk patients and develop targeted intervention strategies.

With access to centralized data on claims, diagnoses, treatment, follow-up care, referrals, care plans, and more, payers can gain full visibility into the used services and ensure they are utilized appropriately. Advanced CCS allows insurers, managed care providers, and other payers to automate the process of prior authorization.