CHRISTUS Trinity Mother Frances Health System Leverages Social Determinants of Health and AI-Driven Predictive Models to Identify High Risk Members

CHRISTUS Trinity Mother Frances Health System Upgrades its VitreosHealth Predictive Analytics Platform with Models for Socioeconomic, Access to Care, and Behavioral Health Insights.

CHRISTUS Mother Frances Hospital – Tyler is ranked # 1 in Texas for overall hospital care, and is among the best in the nation in dozens of categories for clinical excellence and safety (see that CareChex Ranking here). CHRISTUS Trinity Mother Frances Health System operates 82 facilities and 8 hospitals, and covers 41 specialties with over 650 providers. They serve over 1.2 million people spread across 28 counties in Northeast Texas.

CHRISTUS Trinity Mother Frances Health System is a process-centric organization committed to innovation with an analytics-driven culture. They have been using the VitreosHealth Predictive Insights-as-a-Service (IaaS) platform since January 2016 to manage their value-based contracts. Recently, CHRISTUS Trinity Mother Frances Health System has been selected as the “Most Wired” health system for leveraging innovative IT solutions to improve patient care and health outcomes (read more about that recognition here).

VitreosHealth provides AI-driven insights for population health management. Vitreos leverages varied data sources including EHR, claims, Health Risk Assessments (HRAs), social determinants, and well-being data for predictive risk and prescriptive care management. The company offers the solution through its Insights-as-a-Service (IaaS) delivery model. VitreosHealth is changing the economics of healthcare for their clients.

“VitreosHealth is very focused on identifying the right populations for each program, and the right patients at the right time for effective member outreach, to proactively improve health outcomes,” says Scott Smith, M.D., Senior Vice President and Institute Chair of Primary Care, CHRISTUS Trinity Mother Frances Health System. “CHRISTUS Trinity Mother Frances Health System has improved its per-member /per-month cost by 15% and reduced ER Visits/1000 from 74.4 to 50.7 on its targeted population cohorts”.

As part of the Predictive Insights-as-a-Service platform for CHRISTUS Trinity Mother Frances Health System, VitreosHealth utilizes social determinants and behavioral health insights to provide a 360-degree view of the patient. This information is invaluable to the Nurse Navigators and Care Coordinators for educating patients in their care coordination efforts.

“The precision of risk identification and stratification is growing in importance as healthcare providers take on more clinical and financial risk,” says Cynthia Burghard, Research Director, IDC Health Insights. “Important to select a vendor that has a track record for partnership and whose clients can speak of the vendor willingness to solve the problem in terms of improving clinical and financial outcomes.” (Source: IDC Perspective: Machine Learning Improves Precision of Risk Stratification (Doc # US43210617)

About CHRISTUS Health

CHRISTUS Health is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics Page 2/3 If you have any questions regarding information in these press releases please contact the company listed in the press release. Our complete disclaimer appears here and outpatient centers, and dozens of other health ministries and ventures. Sponsored by the Sisters of Charity of the Incarnate Word in Houston and San Antonio and the Sisters of the Holy Family of Nazareth, the mission of CHRISTUS Health is to extend the healing ministry of Jesus Christ. To learn more, visit

About CHRISTUS Trinity Mother Frances health System

CHRISTUS Trinity Mother Frances Health System includes CHRISTUS Mother Frances Hospitals – Tyler, South Tyler, Jacksonville, Winnsboro and Sulphur Springs, the CHRISTUS Trinity Mother Frances Louis and Peaches Owen Heart Hospital – Tyler, CHRISTUS Trinity Mother Frances Rehabilitation Hospital affiliated with HealthSouth, Tyler ContinueCARE Hospital at CHRISTUS Mother Frances Hospital, a long-term acute care facility, and CHRISTUS Trinity Clinic. CHRISTUS Trinity Clinic is the area’s preferred multi-specialty medical group, with more than 650 Physicians and Advanced Practice Providers representing 41 specialties in 82 locations serving Northeast Texas across 41 counties. For more information on services available through CHRISTUS Trinity Mother Frances Health System, visit

About VitreosHealth

VitreosHealth offers the first Insights-as-a-Service delivery model for advanced population health analytics. They leverage Big Data and predictive and prescriptive health insights for population risk models that provide a complete view into the healthcare continuum. Their adaptive insights achieve a patient-centric focus for each perspective within a healthcare organization that leads to quality health outcomes and improves financial performance for a measurable return on investment. VitreosHealth was recently awarded Frost & Sullivan’s 2016 North America Award for New Product Innovation for Advanced Population Health Analytics Solutions. To learn more, visit

Press Contact

Aash Bansal

VitreosHealth – (972) 954-9992

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