HELIOS by VirtualHealth is a leading enterprise medical management platform designed to unify and streamline value-based care delivery for health plans, health systems, and specialty providers. The platform is a comprehensive, cloud-based solution that integrates Care Management (CM), Utilization Management (UM), and Interoperability into a single ecosystem, eliminating data silos and supporting whole-person care, including physical and behavioral health management.
Key Capabilities and Features:
- Integrated Care, Disease, and Utilization Management: Provides a unified workflow for all aspects of care, from population health to utilization review (HELIOSum®), including automated prior authorization and appeals processes.
- Advanced Interoperability & Data Integration: Features HELIOShub®, the first FHIR® Integration Platform as a Service (FiPaaS), which simplifies data exchange and ensures FHIR® compatibility, aggregating clinical, claims, and social determinants of health (SDOH) data into a 360° member view.
- AI-Powered Workflows and Analytics: Utilizes intelligent machine learning and AI-driven automation to predict risks, optimize processes, automate tasks, and expedite configuration, significantly reducing go-live time and improving efficiency.
- Telehealth and Engagement Tools: Includes built-in telehealth features like secure video calls (HELIOSvisit), audio calls, and secure messaging (HELIOStext), which are HIPAA-compliant and do not require a patient download.
- Mobile Care Management: The HELIOSgo® mobile app is available for care teams to manage complex care in the field, supporting long-term services and support (LTSS) and behavioral health.
- Configurability: The platform is highly configurable (up to 90% out-of-the-box) to support specific organizational workflows and requirements as programs expand.
HELIOS is utilized by Fortune 500 companies and manages millions of members, aiming to enhance patient outcomes, increase operational efficiency, and drive data-driven decision-making in a value-based care environment.