Vital Data Technology’s story began in 2005 when leaders at the organization identified an urgent need in emergency healthcare. Emergency medical services (EMS) professionals lacked real-time information on patients prior to arriving at the hospital, which limited their ability to provide accurate and often life-saving treatment. In response, Vital Data Technology’s team developed a solution that provided web-based data analytics in the pre-hospital care field. This pre-Affordable Care Act solution centered on providing a complete digital picture of a person’s health available in real-time to those who needed it most—patients, first responders, hospitals, and emergency department (ED) physicians. Through this work, a much larger issue within the U.S. healthcare ecosystem was identified. While digital transformation is well underway, the fact remains that healthcare costs in the U.S. continue to skyrocket, and the quality of care continues to fall behind other nations. Heightened regulatory requirements and growing competitive pressure from large, national health plans have also increased the need for payer organizations to innovate. Today’s health plans need to simultaneously execute their care management objectives, adapt to emerging requirements without disruption, and drive innovation across the organization.
Vital Data Technology recognized that real payer innovation requires taking a new and holistic approach to data, with more diverse data sources that are incorporated and managed to deliver real-time insights directly within the plan’s medical management platform. With this vision for connecting stakeholders, solutions and data as a foundation, the company’s cloud-native Affinitē platform was officially born. In conjunction with embedded, machine learning data science, the platform risk stratifies, segments, and identifies actionable interventions to empower stakeholders with a 360-degree view of member status, quality, and risk performance. Affinitē embeds robust predictive data models that encompass myriad data points spanning behavioral, clinical, and non-traditional sources including social determinants of health, health information exchanges, case management notes, remote monitoring results, and wearables. With these sources available at the ready, health plans can uncover actionable insights that positively impact member health and increase collaboration with internal and external stakeholders.
Today, the Vital Data Technology data science team has accurately identified thousands of high-risk members, thereby allowing our customers to engage and assist them before their health worsened. Additionally, the organization is continuing to deploy multi-layered risk models, offer personalized action plans, and deliver next-best actions that are essential components of a high-functioning medical and behavioral health program. With Affinitē data science models, health plans can accurately predict which members are the highest risk for certain health conditions, such as depression, diabetes, or pre-term birth, leading to improved health outcomes and cost savings. The data science modeling capabilities can also help teams identify members that are most likely to engage in case management and more likely to be high cost.
As an example, a large Blue Cross Blue Shield client saw the several improvements to their care management performance within the first year without increasing staff including, outreach increased by 56 percent, members enrolled in care management via outreach increased by 50 percent, hospital admissions decreased by 5.9 percent, and ED visits decreased by 2.9 percent. Additionally, the same client automated parts of its workflow and saw several positive results including a 60 percent reduction in time to open a case, an 87 percent increase in care management referrals, a 30 percent increase in new cases, and a 9 percent increase in active cases managed.
Vital Data Technology’s support now extends to all plan types across the healthcare ecosystem, including those operating in Medicaid, commercial, exchange, Medicare, and behavioral health. The company’s current clients include a small regional health plan as well as a large Blues plan with millions of members. In 2022 and beyond, leaders at the organization say they are going to continue to expand and transform the healthcare ecosystem by empowering healthcare stakeholders with prescriptive insights to improve member health and lower costs.
