Care coordination process design with Care Orchestration capabilities
Key Takeaway
In Care Orchestration, care plan recommendations from assessment answers need three pieces: a Discovery Framework assessment, a mapping of questions and responses to recommendations, and a decision table that processes that mapping.
Care Orchestration is the group of Agentforce Health features for care management and care coordination. These features control when, where, and how patients and members receive care. When you design a care coordination process, you match each business requirement to these features.
What Care Orchestration covers
Care Orchestration is one of the Agentforce Health feature groups. Its focus is the actual delivery of care to patients and members. The other groups are Patient and Member Services, Provider Network and Relationship Management, and Utilization Management.
Care Orchestration works like this for care coordinators, patients, and payers:
- Care coordinators assess patient needs, find gaps in care, manage referrals to the right providers, and alert clinicians to patient changes.
- Patients close care gaps and enroll in suitable programs.
- For payers, Care Orchestration covers eligibility, enrollments, care plans, and social determinants, and it keeps members engaged in their health.