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OPCOne+ Population Health Management Service 

In a rapidly evolving healthcare landscape, proactive, data-driven decision-making is essential. The OPCOne+ Population Health Management Service equips healthcare teams and industry with insights to improve patient outcomes, address health disparities, and optimise care delivery across diverse patient populations. OPCOne+ integrates with electronic health records and other data sources, providing comprehensive analytics that enable population health strategies for both preventive and chronic care management. 
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OPC delivers primary-care PHM solutions in: 
  • UK: ~1,200 GP practices; 
  • Australia: 22 primary-care sites;  
  • US: 3 integrated healthcare systems,  
This experience allows OPC to scale PHM solutions effectively across diverse healthcare settings and populations.  

Elevate Care with OPCOne+ 

OPCOne+ offers a full suite of population health management tools tailored to help healthcare providers make an impactful difference. From identifying at-risk patients to optimising interventions, OPCOne+ is built to support your clinical goals and enhance patient care. 

Advanced Analytics for Data-Driven Insights 

Our platform aggregates and analyses patient data, providing a holistic view of the population's health, be it at a single practice level or at an Integrated Care System level. It supports predictive insights to identify high-risk patients, enabling providers to make timely interventions and improve clinical outcomes across large patient cohorts. 

Configurable Care Pathways and Quality Measures 

OPCOne+ enables practices to establish custom care pathways aligned with clinical priorities and quality benchmarks. Providers can measure and monitor adherence to clinical standards in areas such as (but not limited to) respiratory care, diabetes management, hypertension control, and preventive screenings. 

Key Features of OPCOne+ Population Health Management

Patient Stratification and Risk Prediction 

OPCOne+ provides robust tools for stratifying patients based on risk levels, allowing healthcare providers to identify those who may require closer monitoring or preventive care. Predictive analytics highlight patients who are likely to experience adverse health events, enabling earlier, more targeted interventions. 

Enhanced Care Coordination Tools 

Improve continuity of care with integrated care coordination tools that streamline communication across the healthcare team. OPCOne+ facilitates the sharing of patient information and care plan considerations to ensure patients receive comprehensive, cohesive care regardless of where they are in their health journey. 

Integrated Quality Metrics Dashboard 

Track, measure, and report on quality metrics with ease. OPCOne+ dashboard displays key performance indicators in a centralised view, helping teams to monitor progress on important metrics such as vaccination rates, screening adherence, and chronic disease management outcomes. 

Patient Outreach and Engagement 

OPCOne+ enables healthcare providers to reach out to patients for preventive care and educational materials, encouraging adherence to care plans and boosting overall patient engagement. 

Community and Population Health Insights 

Healthcare providers today need more than individual patient data; they need community-level insights to address health disparities and improve outcomes on a broader scale.

Social Determinants of Health Integration:  

Addressing social factors is essential in delivering comprehensive healthcare. OPCOne+ allows providers to incorporate social determinants of health into patient profiles, helping identify socioeconomic, environmental, and behavioural factors that may impact health outcomes. This capability aids in tailoring interventions to the needs of specific patient populations. 

Customisable Community Health Dashboards:

Access community-level data to identify health disparities and resource gaps. OPCOne+ helps visualise trends in health outcomes across different demographic segments, assisting providers in designing outreach initiatives and allocating resources more effectively.  

Secure, Compliant, and Ready to Scale 

At OPC, we prioritise data privacy and security, ensuring that your population health management efforts meet regulatory standards and are protected by best-in-class security measures. 

Compliance with Data Protection Regulations: 

OPCOne+ adheres to strict data governance standards, ensuring that patient information is securely stored and only accessible to authorised personnel. Our solution meets regulatory requirements, including GDPR and other privacy laws, so you can focus on patient care with confidence. 

Scalable for Growing Practice Needs:  

Designed to accommodate growth, OPCOne+ scales with your practice as your data needs expand. Whether you’re managing a single clinic or multiple locations, OPCOne+ provides seamless access to a full suite of population health management tools. 

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Unlocking Value with OPCOne+  

With OPCOne+, healthcare providers can confidently take their population health management to the next level. Our service supports you in developing a comprehensive understanding of patient needs, optimising care delivery, and achieving measurable improvements in health outcomes. 

Case Study

Our “CONQUEST” PHM programme supports high-risk-modifiable COPD-patients. Implemented across 26 ICBs in the UK and three integrated healthcare systems in the USA, OPCOne+ facilitated the integration of electronic-health-records (EHR) from 296 primary-care sites, identifying over 2,000 high-risk-patients (risk of increased hospitalisations, cardiac disease, steroid related side-effects and mortality) including 340 previously undiagnosed cases. Our dashboards allowed healthcare teams to monitor key health metrics and deliver targeted interventions, contributing to improved patient outcomes.

Publication Link: CONQUEST | OPC Global

Case Study

During the COVID-19 pandemic, OPC adapted its PHM solutions to assist healthcare providers in managing over 129,000 patients with long COVID. Our platform enabled real-time tracking and early interventions, demonstrating its flexibility in addressing urgent public health challenges.

Publication Link: Characteristics of patients in platform C19, a COVID-19 research database combining primary care electronic health record and patient reported information | PLOS ONE
 

Discover the Benefits of OPCOne+  for You 

Transform your approach to healthcare with data-driven insights and a proactive care strategy. Get in touch to learn more about OPCOne+ and request a personalised demonstration of how our service can enhance your practice’s impact on population health. 

Email us : opcone-phm@optimumpatientcare.org  ​

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