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Season 1, Episode 2




"The only way to proactively identify and manage members with rising risk is by connecting care teams with real time data, analytics, and predictive models."

Historically, member outreach and interventions were targeted to high risk members to help them manage their existing health conditions. There were problems with this model and the data to support it was entirely reliant on historical data, claims data which didn’t reach healthcare workers in a timely manner. The industry realized that this wasn’t working. The industry shifted to a proactive model to reach and influence the broader population prior to a health event. This model is good for resources and good for members and their families. The only way to proactively identify and manage members with rising risk is by connecting care teams with real time data, analytics, and predictive models.

Today’s care management teams can intervene in more effective ways and provide a superior member experience when powered by a variety of data streams such as EMR, social determinants of health, clinical lab data, utilization data. But having data and analytics is not enough. The data and analytics have to be used in meaningful ways to support diagnosis and treatment. This is where there’s a lot of opportunity in care management—integrating analytics into actionable provider workflows to recommend next-best-action.

In this episode, we'll explore ways to coordinate care with real time data, practical uses for data and analytics for diagnosis and treatment, as well as the ideal care management dashboards for frontline healthcare workers, managers and directors of care management programs.

In this episode we'll discuss: 
01:26 Origins of care management
03:36 Reactive vs. proactive models
04:26 Coordinated care with real-time data
12:48 Practical uses for data and analytics
14:38 Ideal care management dashboard
16:29 Impactibility measures
18:18 NLP & Patient Activation Method (PAM)


Our Our Guest: Dr. Chris Johnson is the Symphony Product Lead at Advantasure, designing and implementing health management solutions for government-sponsored health plans. Building upon academic training in medicine, public health, and medical informatics, Dr. Johnson, pioneered new work- flow methods at companies such as Dignity Health, Zynx Health, and Adventist Health. He co- founded Performance Clinical Systems (PCS) to develop the Symphony workflow concept. With Symphony’s acquisition by Advantasure in 2019, Dr. Johnson now leads a growing team to create effective solutions for health payers and provider networks.

Resources: Baclic, O., Tunis, M., Young, K., Doan, C, Swerdfeger, H., Schonfeld, J. (2020). Challenges and opportunities for public health made possible by advances in natural language processing. Cana- da Communicable Disease Report, 46(6): 161-168. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC7343054/ 

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This podcast is sponsored by Advantasure—managed service and technology solutions for government-sponsored health plans.