Population Health

population health management software

Population Health Management: Solutions for More Efficient Care

Your Population Health Management Partner

Care Planning

Gain a holistic view of the overall health and wellness of each patient using a cross-functional care team to monitor daily activities.

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Chronic Care Management (CCM)

Manage care and promote better health outcomes for patients with multiple chronic conditions who are eligible for Medicare or managed-care programs.

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Transition Care Management (TCM)

Help ensure continuity of care for patients moving between acute and ambulatory settings, and better understand who is being hospitalized and why.

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Care Plan Oversight

The eClinicalWorks Care Plan Oversight module helps practices manage patients’ post-acute care and provide home health supervision (certifications/recertifications) and time-based services.

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Remote Patient Monitoring

The healow Remote Patient Monitoring (RPM) module gathers physiological data from patient wearables and trackers to monitor patient health, gain insights, interpret health trends, and capture time-based activities.

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Hierarchical Condition Category (HCC)

Identify coding gaps based on historical coding data, display secondary manifestation codes, and update RAF scores at the point of care.

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HEDIS® Measures

Choose from more than 100 clinical quality measures designed to improve healthcare delivery, measure compliance, and evaluate provider performance.

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Disease Explorer

Gain better visibility and sharper insight into your patient population to target high-risk patients and prioritize care for those who need immediate attention.

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Cost and Utilization Explorer

Gain access to Medicare claims data that can yield insights needed to meet the challenges of value-based healthcare models.

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Patient-Centered Medical Home

Use this self-guided operational improvement program to put your patients at the center of your practice.

Learn More >

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Your Population Health Management Partner

Care Planning

Gain a holistic view of the overall health and wellness of each patient using a cross-functional care team to monitor daily activities.

Learn More >

Click to enlarge

Chronic Care Management (CCM)

Manage care and promote better health outcomes for patients with multiple chronic conditions who are eligible for Medicare or managed-care programs.

Learn More >

Click to enlarge

Transition Care Management (TCM)

Help ensure continuity of care for patients moving between acute and ambulatory settings, and better understand who is being hospitalized and why.

Learn More >

Click to enlarge

Care Plan Oversight

The eClinicalWorks Care Plan Oversight module helps practices manage patients’ post-acute care and provide home health supervision (certifications/recertifications) and time-based services.

Learn More >

Click to enlarge

Remote Patient Monitoring

The healow Remote Patient Monitoring (RPM) module gathers physiological data from patient wearables and trackers to monitor patient health, gain insights, interpret health trends, and capture time-based activities.

Learn More >

Click to enlarge

Hierarchical Condition Category (HCC)

Identify coding gaps based on historical coding data, display secondary manifestation codes, and update RAF scores at the point of care.

Learn More >

Click to enlarge

HEDIS® Measures

Choose from more than 100 clinical quality measures designed to improve healthcare delivery, measure compliance, and evaluate provider performance.

Learn More >

Click to enlarge

Disease Explorer

Gain better visibility and sharper insight into your patient population to target high-risk patients and prioritize care for those who need immediate attention.

Learn More >

Click to enlarge

Cost and Utilization Explorer

Gain access to Medicare claims data that can yield insights needed to meet the challenges of value-based healthcare models.

Learn More >

Click to enlarge

Patient-Centered Medical Home

Use this self-guided operational improvement program to put your patients at the center of your practice.

Learn More >

Click to enlarge

Customer Success With Our Population Health Solutions

Adult Medicine of Lake County

Find out how Adult Medicine of Lake County used eClinicalWorks Population Health management solutions to improve the visibility of each patient’s case, better coordinate programs, and meet the demands of value-based care.

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Brown Clinic

See how having a strong Population Health partner and solutions helped lower the risk of provider burnout, improved a number of screening compliance rates, and bettered the overall health of this practice’s patient population.

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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

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