Population Health

Our agentic AI suite for Population Health uses intelligent workflows to manage Quality, Visits, and Care across patient populations. Agent extract and analyze FHIR enabled EMR data to track metrics continuously and proactively intervene. For instance, 71% of health systems report active FHIR use for data exchange, meaning our agent can access up to date patient records in any certified EMR. Unity AI agent “speaks” healthcare standards (HL7/FHIR) to interact with clinical systems, ensuring reliable, secure data flow. Unlike passive analytics tools, agent initiate care actions on behalf of the care team.

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Achieving Excellence in Care Quality 

Track, measure, and improve patient outcomes with robust quality management tools. Our platform ensures clinics remain aligned with quality benchmarks and proactively addresses gaps in care.

  • Patient-Level Quality Tracking: Unity Agent continuously analyze each patient’s record to monitor compliance with quality measures. For example, an AI agent flags gaps in care and updates the care team on who needs attention.
  • Real-Time Alerts: When a patient’s data falls below a quality threshold, the system immediately notifies clinicians. These automated alerts enable rapid intervention, for instance, an agent might alert a nurse if a diabetic patient’s HbA1c is out of range, prompting timely follow-up.
  • Proactive Engagement: Our agent reach out to patients automatically through their preferred channels. Personalized reminders and educational messages (e.g. about upcoming screenings or chronic care steps) are sent without manual effort, improving adherence to care plans. This continuous outreach keeps patients on track with quality goals, so care remains proactive rather than reactive.

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Driving Preventive and Proactive Visits

Our Agent helps clinics ensure patients receive the right care at the right time, supporting Value Based Care goals. By focusing on preventive care, timely follow-ups, and risk mitigation, Unity Agent help providers optimize patient interactions and improve health outcomes.

  • Preventive Care Optimization: AI agent identify patients due for preventive services and schedule appointments automatically. Integrated with the EMR scheduling system, the agent can fill open slots and reduce no-shows, enabling clinics to focus on care, not paperwork.
  • Post ER Follow-Up Coordination: Our agent monitor admissions and urgent visits. After an emergency encounter, an AI workflow automatically triggers a post-discharge care plan, confirming follow up appointments and sending recovery instructions.
  • Unattributed to Attributed: The system finds unattributed patients by analyzing EMR and Payer data. Agentic routines then connect each patient to an appropriate provider for ongoing management.

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Personalized and Coordinated Patient Care

Deliver exceptional care through coordinated and patient centered solutions. Our Agent enable clinics to enhance engagement, streamline workflows, and deliver personalized care plans.

  • Care Coordination
    Unity Agent automatically share tasks, alerts, and patient updates across care teams using FHIR standards. This eliminates manual handoffs and ensures every clinician works with the latest information.
  • Patient Engagement
    Personalized outreach is delivered via text, voice, and email based on real-time clinical signals. Patients stay informed, engaged, and more likely to follow through with their care.
  • Personalized Care Plans
    Individualized care plans are generated from each patient’s clinical data and continuously updated. Labs, medications, and appointments stay aligned as conditions and needs change.
  • Chronic Disease Management
    Specialized agents monitor vitals, labs, and medications to detect early risk signals. Care teams can intervene sooner to prevent complications and avoid hospitalizations.

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Empower Your Population Health Team

Discover how Unity enhances outcomes, improves coordination, and optimizes population management. Learn More

Accelerating Population Health Success

Unity’s Agentic AI transforms population health from passive monitoring into continuous execution. Automating care gap closure, visit optimization, and coordinated outreach directly within the EMR to drive measurable clinical and financial outcomes.

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Improve Health Outcomes

Enhance overall population well-being through proactive care.

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Enhance Preventive Care

Reduce risks with early interventions and screenings.

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Optimize Care Coordination

Ensure seamless collaboration across providers and systems.

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Boost Patient Engagement

Empower individuals to take charge of their health.

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Reduce Care Gaps

Minimize disparities by ensuring timely interventions.

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Maximize Risk Stratification

Identify high-risk populations for targeted interventions.

Transforming Population Health Outcomes

Harness data-driven insights to improve care, reduce disparities, and drive better health outcomes at scale.

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100%

Data Driven

Commitment to proactive, data-driven population health.

80%

Targeted Interventions

Reduction in avoidable hospitalizations with targeted interventions.

4.8/5

Provider Satisfaction

Provider satisfaction in managing population health effectively.

70%

Preventive Screening

increase in preventive screenings and early interventions.

50%

Disease control

Improvement in chronic disease management through analytics.

30%

Cost Reduction

Reduction in overall healthcare spend by closing care gaps.

Agentic AI Powered, EMR Integrated Solutions to Accelerate Value-Based Care. Get Started Today!