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November Edition 2023

An innovator delivering the first cloud-based solution for value-based care: VirtualHealth


VirtualHealth is on a mission to make healthcare more proactive and equitable through technology. VirtualHealth’s HELIOS® platform is the country’s leading enterprise technology for care management, disease management, utilization management, and population health management. The company values innovation, believe in a member-first approach to care, and are dedicated to delivering technology solutions that empower healthcare organizations to deliver the best care to their members. Innovation is ingrained in the company’s culture. From day one, the company has been dedicated to bringing value to every client and partner, ensuring that each VirtualHealth product enhancement meets a true business need while fully supporting regulatory compliance.

Among many other firsts, VirtualHealth was the first in its space to commit to the cloud, to pilot connected devices, to integrate transportation vendors, to incorporate patient incentives, to offer built-in telehealth, to support comprehensive FHIR API coverage, and to provide configurable robotic process automation (RPA). VirtualHealth’s team is built of healthcare, business, engineering, IT, and technology experts who are continually focused on expanding the capabilities of HELIOS. And VirtualHealth’s ecosystem of partners includes industry leaders that are equally as focused on improving health equity, solving SDOH, and enabling better care at affordable costs.

Supporting a Comprehensive Approach to Whole-Person Care

For clinical teams to make effective healthcare decisions, they need data and insights to be connected and shared. But healthcare data is often too fragmented to be meaningful. To solve this, VirtualHealth’s team developed custom integrations with dozens of payer and provider platforms that bring disparate data together into a holistic view for the care team that includes all patient data.

And to make this wealth of data actionable, VirtualHealth developed intelligent workflows that could react in real time to relevant events in any part of the healthcare system. From hospital admissions to physician encounters to authorization requests, HELIOS is the essential workbench for the modern healthcare payer, combining data and intelligence into actionable insights for care teams, utilization management teams, and others across the continuum.

Finding a Platform that Will Help, Not Hurt, Job Satisfaction

Rather than contribute to burnout, effective care management software will serve as a tool to boost job satisfaction and overall happiness. Through automation, AI, and centralized data access, software can empower care team workers to:

Build strong relationships with members. With quick access to member demographics and other relevant data, care managers can make authentic connections that spark engagement. Automated alerts that keep care managers updated on transitions of care or other events help them intervene immediately, securing trust (and better outcomes). In-platform capabilities like text messaging, emails, and video conferencing support fast, reliable communication with members.

Offload the mental stress of having to remember so many critical tasks. A system that triggers automated reminders for tasks like member or provider follow-up, or provides real-time alerts on care transitions, reduces the cognitive burden for care managers. (They might even be able to break up with sticky notes…)

Make decisions regarding care management services and support with more confidence. Software with clinical and care coordination pathways removes the guesswork (and the need for a whole lot of manual searching) to determine best practices for assessments, interventions, and parameters and timelines for follow-up.

Work more productively and efficiently. The more efficiently care managers can work, the more cases they can take on – which they know is a major goal of the job. Software can alleviate administrative burdens by automating manual tasks. For example, documentation can be streamlined by limiting free-text documentation and pre-populating fields when possible.

Work more collaboratively with interdisciplinary teams, providers, and payers. With a centralized member record, everyone involved in care stays in synch on care notes, assessments, progress, interventions, and claims data. This promotes continuity of care for the member and gives the care team time back that they would have spent hunting for information.

Achieve closed-loop visibility to bridge care gaps for members. Well-designed software tracks and alerts care managers when a member has followed through on an appointment, for example, or a referral for a community resource like food assistance. This functionality makes it much easier to close care gaps and saves time spent on manual follow-up.

Take the stress out of quality reporting and measuring. Tracking these measurements is critical to the success of a care management program – and compliance is on the line, too. But it’s easy for staff to miss documenting the required metrics related to SLAs and regulatory standards. A platform helps in a couple of key ways:

  • Standardizing documentation forces users to include required components.
  • Reporting dashboards serve as one-stop-shops to help care managers easily grab critical metrics, saving a lot of time.

With more than a decade of experience helping care teams work smarter and faster, VirtualHealth has discovered some common themes around what works (and what doesn’t) when it comes to care management technology. Designed as a unified ecosystem of care for the modern care team, HELIOS provides broad spectrum visibility across the entire healthcare continuum, enabling seamless collaboration, coordination, and care delivery. HELIOS is available in different product tiers and configuration levels. What makes HELIOS stand out from other enterprise healthcare management platforms? HELIOS® is the most configurable platform in the market – nearly 90% configurable out-of-the-box with point-and-click tools that can be leveraged by any business user. It’s also the most intuitive platform, with fewer clicks and views calibrated for more efficient, effective usage.

Simple and easy to learn, HELIOS offers precision control over the industry’s most sophisticated templates, advanced rules engine, and automated workflows.

Adam Sabloff, CEO and Founder

“VirtualHealth is on a mission to help healthcare organizations deliver equitable value-based care through next-generation care management and utilization management software designed for today’s digital age.”