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CitiusTech: Healthcare Technology Specialists

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William Winkenwerder, Jr. Chairman & MD, CitiusTechWilliam Winkenwerder, Jr. Chairman & MD, CitiusTech For a leading Blues health plan on the east coast providing quality healthcare services to more than 4 million members, it was getting difficult to devise a robust quality reporting and analytics solution to achieve near real-time output with custom measures and multiple reporting periods. The company also wanted the solution to integrate administrative and clinical data from varied source systems, which made the entire process even more tedious. That’s where CitiusTech came into picture. CitiusTech defined the requirements for the HEDIS rules engine and the analytics user interface. A team of BI-Clinical, consulting, clinical informatics, Tableau user interface, data implementation and QA experts was formed to collaborate with client teams to implement the desired solution. The CitiusTech team implemented the BI-Clinical platform which provided modular, flexible and configurable measure score computation and reporting capabilities. BI-Clinical also offered scalability for additional use cases.

And the results were stupendous. BI-Clinical enabled the client to lower the time to deploy custom measures by 78 percent and provided near real-time information, enabling prompt assessment and analysis of care gaps. The solution helped the client increase the number of visits processed per hour by 77 percent. This enabled the client to carry out daily measure processing for its Medicare Advantage line of business.

The example stands as a testament to the success that CitiusTech have had in leading the way in the healthcare security arena as a specialist provider of healthcare technology services and solutions to healthcare technology companies, providers, payers and life sciences organizations. The company has been instrumental in helping customers accelerate innovation in healthcare through specialized solutions, healthcare technology platforms, proficiencies and accelerators.

Delivering Optimum Security

Transforming business models and evolving quality and regulatory requirements (MACRA, HEDIS, CMS STAR, ACO,HCC, PCMH, etc.) have driven the need for organizations to enhance their BI / analytics strategy. However, organizations often use disparate solutions to meet BI / analytics and reporting needs. With massive volumes of diverse healthcare data being generated each day, these disparate solutions often lead to significant long-term challenges around data management, clinical quality and performance management. Healthcare organizations need an integrated, sustainable and scalable approach towards BI / analytics and reporting, to effectively meet current and future needs. With rising costs of care and fast-changing regulatory mandates, health plans need to invest in technology solutions that drive value-based care. They face multiple challenges around risk stratification, population health, accountable care and regulatory challenges like HEDIS and STAR. Well-positioned to help health plans drive clinical value chain excellence, CitiusTech offers a comprehensive suite of services, platforms and solutions across a wide range of payer needs.

CitiusTech’s BI-Clinical platform for healthcare BI / analytics is NCQA certified for all HEDIS 2018 performance measures. CitiusTech’s SCORE+ for HEDIS is an end-to-end suite for real-time HEDIS reporting, provider collaboration and accelerated gap-closure.


As a leader in healthcare data and information management, CitiusTech has been very successful in helping healthcare organizations leverage technology to reduce costs, drive better patient outcomes and optimize performance


The company also provides best-in-class management consulting expertise through FluidEdge Consulting, which focuses on strategy, operational analysis, regulatory compliance, quality programs, technical evaluation and project management. Through a strong health plan network, FluidEdge has access to a large number of health plan-focused resources with knowledge of core claims processing systems, provider data management systems and care / medical management systems.

An Integrated Approach to Healthcare Security

CitiusTech’s healthcare BI and analytics platform, BI-Clinical offers an integrated approach to address the healthcare organization’s most critical healthcare reporting and decision support needs. It offers an extensive range of configurable apps that cover over 900 KPIs for clinical, financial, operational and regulatory requirements—the largest measure library in the industry. BI-Clinical’s high-performance rules engine enables organizations to configure and deploy custom quality measures based on their business requirements and is scalable to process up to 100 million patient records per day.

"BI-Clinical enables healthcare organizations improve clinical performance, manage shared-risk models, and align with federal and commercial incentive programs"

BI-Clinical offers exceptional flexibility and ease of use through its Rules Management Module (RMM), the first and only tool in the market for seamless rule definition and configuration. RMM, empowers quality management teams to configure, audit and operationalize regulatory, contractual, operational and other rules (cohorts and alerts), without any dependency on IT. What really differentiates BI-Clinical is its comprehensive coverage of federal/commercial incentive programs, and flexible, extensible and interoperable architecture which enables companies with multi-server architecture and SaaS deployment option for easy integration and rapid scalability. The platform also delivers multiple modules to the security mechanism in a care continuum. “BI-Clinical enables healthcare organizations improve clinical performance, manage shared-risk models, and align with federal and commercial incentive programs,” says Bimal R. Naik, the Chief Client Officer of CitiusTech. “The modular app architecture, browser-based access, extensive support for mobile devices, and web services integration simplifies deployment, allowing organizations to respond to changing industry needs quickly and cost-effectively.”

Modules that Enhance Security

BI-Clinical’s Rules Management Module BIC-RMM is a first of-its-kind comprehensive solution which gives organizations the ability to build, edit and manage CQMs, rules and cohorts quickly and efficiently. It provides an easy-to-use, do-it-yourself interface for clinical, regulatory, contractual and operational rules. BIC-RMM empowers business users to configure and operationalize CQMs, cohorts and alerts without any dependency on IT. It leverages BI-Clinical’s high performance Rules Engine to process and deploy pre-built as well as custom measures and KPIs. BIC-RMM enables healthcare organizations to accelerate clinical, regulatory, contractual and operational reporting needs by reusing 900+ pre-built rules or implementing custom KPIs.

They can also improve measure correctness significantly with better version control and an automated process that reduces manual errors. Further, they can also create and reuse value sets, codes, conditions, rules, etc.—enabling faster and more accurate rule creation (below 5 minutes to import / export value sets).

On the other hand, the BIC-Audit Module delivers comprehensive, real-time audit and traceability of clinical measures, cohorts and rules. With increasing focus on value-based care and measuring quality of care delivered, organizational readiness for audit needs will be a key factor in successful compliance. BIC-Audit is a one-stop solution that offers a comprehensive way to address the healthcare organizations’ diverse audit requirements. BIC-Audit enables organizations to generate real-time audit reports across financial, contractual, operational and regulatory domains leveraging 900+ pre-built KPIs supporting multiple programs including CMS and NCQA. It provides physicians, quality management professionals, practice administrators and third-party vendors with a simple, self-service interface to not only generate audit reports but also to determine the correctness of measure calculations, ensuring compliance.

Accelerating Innovation in Healthcare

Over the years, CitiusTech has carved a unique niche itself in the healthcare technology space. With over 3,500 professionals worldwide, CitiusTech’s services and solutions include healthcare software development, healthcare interoperability, regulatory compliance, BI/analytics, consumer engagement, care coordination and population health management. The company has also appointed William Winkenwerder, Jr., MD as the new Chairman effective November 15, 2017, which it believes will accelerate their growth.

Dr. Winkenwerder is recognized as a healthcare industry expert and has significant experience across health insurance, healthcare providers, federal healthcare and health information technology. “I am excited to take on this role,” says Dr. Winkenwerder. “The healthcare industry is going through a rapid phase of evolution and technologic change. As a leader in healthcare data and information management, CitiusTech has been very successful in helping healthcare organizations leverage technology to reduce costs, drive better patient outcomes and optimize performance.”

In his new role as the Chairman, Dr. Winkenwerder will continue to steer the company towards achieving its vision of creating distinctive and superior solutions and services for the global healthcare industry. He will play a significant role in defining the organization’s strategic roadmap for key markets including providers and health plans. Dr. Winkenwerder will also help CitiusTech drive innovation through its key focus areas - healthcare enterprise applications, data management, performance management, and data science and consulting. He will also be closely involved in supporting and enhancing CitiusTech’s leadership team.

CitiusTech will also be showcasing its BI-Clinical (Healthcare BI / analytics) and H-Scale (Healthcare data management) solutions as part of the Microsoft Intelligent Health Booth at the HIMSS Annual 2019 Conference. “CitiusTech and Microsoft have a long-standing partnership of over 10 years, supporting more than 50 leading healthcare organizations. As a Microsoft Gold Partner for competencies around cloud, application integration and data analytics, CitiusTech works closely with Microsoft to help customers drive innovation and leverage technology to bring down the cost of care,” informs Manish Sharma, the Senior VP of Strategy and Partnerships of CitiusTech. “We are thrilled to be joining Microsoft at HIMSS 2019 and showcasing our solutions and capabilities.”