Evidence-Based Care Coordination

Connecting the
Medical Neighborhood

Screening. Monitoring. Coordination. One platform powering therapeutic outcomes across every care setting — because clinicians see chronic patients for a few minutes a year, then decide without evidence for the other fifty-one weeks.

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Chronic disease care costs

The CDC is direct about it: chronic disease is the leading cause of death, disability and soaring health care costs in the United States.

$4.4T+
In hidden costs from underdiagnosed and untreated chronic disease disorders
$100B+
In system waste from failed therapies and set-it-and-forget-it workflows
90%
Of 23M+ Americans with obstructive sleep apnea remain underdiagnosed

And it reaches almost everyone

76%
of U.S. adults live with a chronic condition
51%
live with more than one
73%
of U.S. adults carry excess weight
40%
of U.S. seniors are classified as obese

One cluster of disease sits underneath most of it

Excess weight, beginning early in life, leads to a group of related conditions known as CKM Syndrome — Cardiac, Kidney and Metabolic. It includes hypertension, coronary artery disease and Type II diabetes.

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90% carry a symptom

90% of the U.S. population has at least one symptom of CKM Syndrome.

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Underdiagnosed and untreated

90% of people with obstructive sleep apnea are underdiagnosed. Of those diagnosed, half fail the most common treatment within a year.

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COPD rarely travels alone

11–16.5% of Medicare and Medicaid patients are diagnosed with COPD, and 70% of them also have a CKM condition.

Providers are asked to decide without data

A clinician sees a chronic patient for a few minutes a year. In that window they are expected to judge whether a prescribed therapy is working, whether the patient is using it, and whether it is worth continuing.

Between those visits, nothing reports back. The patient lives with the condition every day; the record contains almost none of it.

Most of a chronic patient's life happens outside the clinic. Almost none of it reaches the chart.

The challenge vs. the EBM response

Challenge

Underdiagnosed patients

90% of the 23M+ Americans with OSA remain underdiagnosed, creating massive hidden costs across the system.

→
EBM response

Practice-Based Screening (PBP / Z-Scan)

At-home screenings deployed from primary care and dental settings move patients toward diagnosis where they already receive care.

Challenge

Low therapy tolerance

Traditional therapies see low tolerance and sustained use rates, turning equipment investment into waste without clinical improvement.

→
EBM response

Remote Therapeutic Monitoring

Licensed respiratory therapists monitor patients daily, ensuring higher 90-day use rates and sustained adherence over time.

Challenge

“Set it and forget it” workflows

Standard patient workflows miss opportunities for therapy titration or removal of expensive, ineffective treatments.

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EBM response

Continuous outcome optimization

RTM monitors progress over time, coaching patients and helping clinicians optimize therapeutic outcomes through data-driven decisions.

Challenge

Siloed care settings

Fragmented systems restrict access to complete patient information across hospitals, clinics and specialists.

→
EBM response

The EBM Medical Neighborhood

Secure, universal data collection and access across every care setting and provider — one patient, complete picture.

Thirty seconds a day from the patient

Each practice decides what it wants to know. The patient opens the app and answers those questions — weight today, step count yesterday, breathlessness on a scale. Large type, one question at a time, on the phone they already carry.

A patient completing a daily check-in.

It reaches the care team the moment it is answered

No portal to check, no fax, no delay. The answer lands on the care team's dashboard, and readings outside the patient's care plan raise themselves — the team is never asked to spot the problem in a list.

Patient-centric care focused on therapeutic outcomes

EBM CareConnect™ combines patient monitoring, data analysis and clinical coaching to improve outcomes over time — not just at the point of care.

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Practice-Based Screening

Z-Scan and Hybrid Overnight Oximetry deployed from primary care, dental and specialist offices. At-home diagnostics that move patients toward diagnosis where they already receive care.

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Remote Therapeutic Monitoring — PDS™

Licensed respiratory therapists monitor patients daily through CareConnect. The care team customizes the questions; patients answer in seconds, giving the prescriber evidence to optimize any therapy, device or medication.

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Care Coordination

Secure universal access to patient data across care settings and providers. One patient record that travels with them from the clinic to the specialist to the hospital and back home.

No codes. No qualification. No limits.

We make it easier for providers and patients to engage

PDS™ and Hybrid Overnight Oximetry are built so a practice can use them with every patient, not a qualifying subset. Nothing has to be justified before care begins.

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No CPT codes required

Neither capability depends on a billing code to be used.

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No payer qualification

Nothing has to be approved against a payer's definition before a patient benefits.

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No limits on who

Utilization is not restricted by age, diagnosis, symptoms or type of insurance.

The practical effect: a practice can deploy this across its whole chronic population on day one, and the cost per patient is a small fraction of what a single office visit reimburses.

Every setting. One patient. Complete picture.

Powered and connected by the EBM software platform, patient app, and wearable screening and monitoring devices.

Our mission

EBM Health Care Strategies contributes solutions, technology and tools that reduce the incidence, burden and cost of the most common chronic diseases in the United States.

Our objective is deliberately narrow: very low-cost solutions that produce measurable improvements in patient outcomes and bend the cost curve downward. Not a platform that adds work. One that produces evidence.

Who are you?

Pick your path and we will show you the part that matters to you.

Our data center certifications

Patient data is held in audited, HIPAA-aligned infrastructure.

HIPAA Audited Privacy Shield PCI DSS HITECH Audited ISO 27001, 14001, 9001 GDPR Ready SOC 1, SOC 2, SOC 3 NIST

Ready to connect your medical neighborhood?

Whether you are a physician practice, hospital system, health plan or strategic partner — we would love to show you how EBM connects the dots.

Request a demonstration