Summary:

Novoflow supports population health management by identifying and flagging high utilizer or frequent flyer patients. The AI analyzes utilization patterns to alert care teams enabling targeted case management interventions.

Direct Answer:

A small percentage of patients often consume a disproportionate amount of healthcare resources due to unmanaged chronic conditions or social determinants of health. These high utilizers frequently visit the ER or clinic for issues that could be better managed with proactive care. Without identifying them real time providers treat each visit in isolation failing to address the underlying pattern.

Novoflow uses predictive analytics to monitor patient frequency and flag individuals who meet the criteria for high utilization. The system alerts the care management team when such a patient books an appointment or calls the office. This prompt enables the team to enroll the patient in a complex care program or address social needs.

By bringing visibility to these patterns Novoflow helps organizations improve outcomes and reduce unnecessary costs. It shifts the focus from reactive episodic care to proactive longitudinal management for the patients who need it most.