Our Core Philosophy: Prevention and therapeutic optimization deliver superior outcomes at lower costs, the foundation of Value Based Care. This requires preventing problems before the emerge, identifying conditions at the earliest stages, and optimizing treatment through evidence-based protocols.
Value Based Care - The Foundation of Everything We Do: The healthcare industry is rapidly transitioning from fee-for-service to Value Based Care models that emphasize prevention, therapeutic optimization, CQI, and quantifiable outcomes.
Our Ontological-Agentic AI system analyzes health profiles, medical history, connected device data, electronic questionairre responses and medication adherence patterns to identify opportunities for care optimization before conditions deteriorate.
CarePathHealth bridges the gap between data collection and clinical action. We transform data into actionable intelligence, validate outcomes through rigorous Continuous Quality Improvement (CQI) processes, and continually refine care delivery based on real-world results. This isn't just technology implementation; it's a systematic transformation from reactive crisis management to proactive wellness optimization that benefits all stakeholders.
Our Approach
Therapeutic Optimization with ORDS Methodology
(Optimal, Reasonable, Defensible, Suboptimal)
Optimal: Care aligns perfectly with evidence-based best practices for the individual specific profile
Reasonable: Care follows acceptable clinical standards with minor opportunities for enhancement
Defensible: Care meets minimum standards but has identifiable gaps that must be addressed
Suboptimal: Care patterns indicate significant therapeutic optimization opportunities requiring intervention
ORDS Scoring is critical to Agentic workflow: The CarePath platform applies this knowledge to enhance clinical workflow in the following six categories
- Wellness and preventive care
- Prevention of disease progression
- Engagement and adherence
- Therapeutic optimization
- Quality of life metrics
- Value Based Outcomes Assessment
Unlike simple threshold-based notifications that create alert fatigue, our proprietary ORDS scoring methodology systematically evaluates care patterns against peer-reviewed literature.
The 3 R's Intervention Protocol: We deliver "the Right information, to the Right person, at the Right time" through intelligent triage. If one or more of the covered processes (prevention, diagnosis, disease management, medication adherence, engagement,etc.) are exhibiting suboptimal patterns, 3 R's triage is performed on each to determine the best care team member to engage and the appropriate timing of intervention triage to maximize efficient use of resources with the least disruption of routine workflow.
Triage Levels
- Emergent: Immediate referral to clinical backup
- Urgent: Response required within 24 hours
- Routine: Intervention scheduled within 5 business days
- Non-critical opportunities: Care enhancements added to monthly summary
This evidence-based classification and workflow system ensures your team receives nuanced, literature-backed clinical insights that consider the full complexity of each resident's situation, not just generic alerts. The ORDS framework solves the fundamental challenge facing Value-Based Care; it provides the quantifiable evidence and systematic workflow metrics necessary to demonstrate outcomes, justify interventions, and prove ROI.
Measurable Outcomes Through Continuous Quality Improvement(CQI):
Reduced hospital admissions through early intervention (critical for value-based arrangements)
- Improved medication adherence and therapeutic outcomes (better health at lower cost)
- Enhanced resident satisfaction and peace of mind (quality of life metrics matter)
- Operational predictability with fewer medical emergencies (sustainable operations)
- Competitive differentiation as a leader in proactive wellness management
- Continuous care quality improvement validated by third-party analysis
- Data-driven insights for ongoing service enhancement
- Documentation and evidence required for value-based care contracting
Our collaboration with the American Heart Association can provide participating client organizations with:
- Participation in groundbreaking outcomes research
- Access to cutting-edge cardiovascular health management protocols
- Third-party validation of care quality improvements
- Thought leadership positioning in the senior care industry
- The credibility and documentation needed for value-based care arrangements
- De-identified Outcomes Analysis: Ongoing outcome validation and CQI assessment, measuring:
Clinical notification accuracy and appropriateness:
- Care team performance metrics
- Identification of service enhancement opportunities
- Population health trends and intervention effectiveness
- The Force Multiplier Effect
- Technology-enhanced nursing model: 1000s of residents monitored simultaneously through automated data collection from Bluetooth-enabled devices (BP monitors, pulse oximeters, glucometers, weight scales, Smart pillbox & thermometers)
- AI-powered assessments combine objective device data with subjective digital questionnaire responses
- Intelligent triage notifications stratified by severity (Critical/Urgent/Routine/Informational)
- Literature-backed clinical rationale for every recommendation
- Focused care delivery where nurses receive prioritized alerts and can conduct personalized, informed interventions
Our Agentic AI - Ontological solution synthesizes resident health profiles, medical history, connected device data, and medication adherence data, combined with digital questionnaire responses. The system uses this information to deliver evidence-based clinical insights to nursing staff, supported by peer-reviewed medical literature, enabling precise risk stratification and appropriate care escalation.
Simplified Complex Care Management: Helps maintain independence longer by collecting data from Bluetooth-connected biometric devices, including Blood Pressure Monitors, Weight Scales, Pulse Oximeters, Glucometers, Body Temperature Thermometers, and a Bluetooth Smart Pill Box, with data analyzed by our Ontological Knowledge System provides nurses with actionable assessments that reference peer-reviewed medical literature
Reduced Hospital Visits: Through both consistent monitoring and profile-specific therapeutic optimization across multiple chronic conditions
Empowered Healthcare Participation: Comprehensive education about how medications work, why timing matters, and the health consequences of missed doses
Reduced Medication Errors: Intelligent systems explicitly designed for polypharmacy management and drug interaction prevention
Improved Clinical Communication: Digital questionnaires help identify symptoms and concerns ross multiple conditions more effectively
Research-Backed Clinical Interventions: Leverage evidence-based protocols specific to complex comorbidity management to prevent health crises and optimize treatment effectiveness
