Athenahealth dials in on value-based care with AI-native capabilities

New AI capabilities in athenahealth's athenaOne platform aim to give healthcare professionals the data they need to succeed in value-based care, the company announced today.

The new AI features span four domains, the first of which is technology that flags clinically inferred diagnosis gaps. Still in beta, this product analyzes the patient chart and flags any undocumented diagnoses that might necessitate attention.

This is important for care planning and appropriate Hierarchical Condition Category (HCC) capture and risk adjustment/stratification.

Another new AI feature suggests personalized care goals that the clinical team can choose to incorporate into care management plans. The goals can be integrated directly into the patient chart, which, athenahealth said, will boost patient engagement and reduce care managers' workload.

As part of that AI functionality, athenaOne can now also provide care event summaries to help providers catch up on what has transpired in other care settings.

Take, for example, a patient who has been admitted to the hospital. A primary care provider using the AI-native tools on athenaOne will be able to review a summary of the hospital stay, which should help them initiate follow-up care plans and ultimately reduce hospital readmissions.

Next, athenahealth launched AI-native data exploration, which is currently in beta.

The AI feature enables population-level reporting, which helps organizations assess their performance against clinical quality measures, flag care gaps and engage in risk stratification. This AI also helps explain why a patient hasn't hit a certain clinical quality measure, which should save providers time manually reviewing patient charts, athenahealth said.

Finally, athenahealth has launched Sage for Analytics, which uses athenaOne's AI assistant to analyze population data, track performance and flag opportunities for improvement.

The AI also features Agentic Care Gap Outreach, which automates the patient engagement and outreach necessary to close care gaps. The AI agents flag patients with a care gap, such as a missed preventive screening or a missed chronic disease check-in, and prepare customized outreach.

Provider offices must review outreach before it is sent, athenahealth confirmed.

Value-based care is a data-heavy venture. Although each value-based care model has different requirements, providers practicing within value-based care environments generally need a whole-person, population-level view of patients to make clinical decisions that support good outcomes and yield cost savings. This is especially important as value-based care models feature more downside risk.

Performing this sophisticated population health data analysis has historically been arduous, requiring healthcare professionals and administrators to manually review data to make clinical decisions. AI has emerged as a critical tool for streamlining this process, and according to Chad Dodd, vice president of product management at athenahealth, the company's technology boasts a wealth of data to fuel the AI.

"AI is only as powerful as the data that fuels it, and our network provides access to one of healthcare's richest data sets," Dodd said in the announcement. "Combined with an architecture designed to deploy AI rapidly and at scale, this enables us to help organizations adapt and thrive as the industry shifts toward value-based care."

Athenahealth said the AI is embedded directly into the athenaOne workflow that clinicians already use. It's not an add-on program being layered over the EHR, which makes for a more streamlined experience, athenahealth said.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.