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How can we improve care and coordination for chronic diseases and comorbidities?

Our users (doctors) find it challenging to coordinate care for chronic diseases and comorbidities because of unclear interrelationships between treatments, providers and facilities.


Baseline Patient
  • Accurately baseline a patient by using patient’s medical history and DX results.
  • View clinical protocol by care plan.
Management of Care Plans
  • Clearly view care plans over time by disease.
  • Progressively disclose relationships between medications prescribed.
  • Quickly view doctors associated with each care plan.
  • Coordinate care plans across multiple diseases and comorbidities without conflicts.
Comparison of Similar Patient Outcomes
  • Efficiently compare outcomes of patients with similar care plans.


1. Look at the data source.

Patient’s Medical Records

These include information about demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.

Treatment Plans across Time by Disease

Clinical Protocol by Care Plan

Population Health Data

2. Slice data to gain insights.

Dominant Dimensions

Care plan items


Primary Data Entities

Patient’s medical records

Outcomes of patients

Algorithm of treatments


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