Chronic Care Risk Stratification: Tile Health vs ChartSpan
Compare Chronic Care Management risk stratification workflows between Tile Health's AI automation and ChartSpan's human-staffed service model.
Managing a Chronic Care Management (CCM) program requires precise risk stratification to prioritize high-risk patients. While ChartSpan relies on human care coordinators to manually review charts and call patients, Tile Health utilizes AI-driven automation to analyze data in real-time, offering a more scalable and cost-effective approach to patient prioritization and intervention.
Traditional CCM models like ChartSpan struggle with scaling risk stratification due to high costs and human error associated with manual chart reviews. Practices face delays in identifying rising-risk patients, leading to missed intervention opportunities and inconsistent care delivery.
Step-by-Step Workflow
EHR Data Ingestion and Synchronization
Connect your CCM platform to the EHR for data harvesting. While ChartSpan often relies on manual exports or batch HL7 feeds, Tile Health uses deep API integration to pull real-time clinical data for immediate AI analysis.
- Ensure your BAA covers AI data processing
- Verify EHR compatibility for real-time syncing
- Relying on monthly batch exports which delay risk identification
Automated Patient Identification
Tile Health's AI scans the entire patient roster against CMS eligibility criteria and specific risk factors. Unlike ChartSpan's human-led identification, this happens instantly across thousands of records without increasing administrative overhead.
- Define specific ICD-10 codes for automated flagging
- Set custom risk thresholds based on practice demographics
- Allowing human coordinators to manually cherry-pick patients based on ease rather than clinical risk
Dynamic Risk Scoring
Apply algorithms to rank patients based on recent ER visits, medication changes, and social determinants. Tile Health updates scores daily, whereas ChartSpan’s human model often updates scores only during scheduled monthly check-ins.
- Integrate SDOH data for a holistic risk view
- Automate alerts for sudden score spikes
- Using static risk scores that do not account for acute clinical changes between human calls
AI-Powered Status Verification
Tile Health initiates AI voice outreach to stratified patients to gather current health status. ChartSpan requires a human coordinator to find time in their schedule, often resulting in lower touch-points for moderate-risk patients.
- Use AI to handle routine check-ins
- Reserve human staff for high-complexity clinical escalations
- Over-relying on human phone tag which delays urgent patient engagement
Clinical Intervention Escalation
When Tile Health's AI detects a high-risk symptom during automated outreach, it immediately alerts the clinical team. In the ChartSpan model, this depends entirely on the coordinator's ability to reach the patient and document the finding correctly.
- Configure instant SMS or dashboard alerts for providers
- Standardize escalation protocols for specific symptoms
- Failing to define a clear hand-off from the AI system to the primary care provider
Automated Documentation and Compliance
Tile Health automatically logs all interactions and risk updates into the EHR for APCM/CCM billing. ChartSpan coordinators must manually document their calls, which increases the risk of non-compliance or missed billing minutes.
- Review AI-generated logs for billing accuracy
- Ensure all time-based activities are captured automatically
- Inconsistent documentation of non-face-to-face time across different human coordinators
Expected Outcomes
90% reduction in manual chart review time for administrative staff
Faster identification of high-risk clinical escalations compared to human models
Significant decrease in cost-per-patient through AI automation
Improved consistency in risk scoring across the entire patient population
Higher patient engagement rates through consistent, automated outreach
Frequently Asked Questions
Tile Health's AI analyzes 100% of patient data daily without fatigue, whereas ChartSpan's coordinators are limited by their caseload capacity and manual review speed.
Yes, Tile Health maintains full HIPAA compliance and signs a BAA, ensuring all automated data analysis and patient outreach meet federal security standards.
While human staff handle nuanced emotional support, Tile Health’s AI excels at clinical data processing and consistent monitoring, escalating only the most complex cases to your in-house clinical team.
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