An Analysis in the Context of The Forrester Wave for Digital Decisioning Platforms

Published December 8, 2020, the Forrester study  

assesses Digital Decisioning Platforms (DDP) and how  

they stack up against market competitors. 

While aimed at general purpose DDPs, the following will  assess the DignifiHealth platform amidst the Forrester context, as it relates specifically to the needs of the healthcare industry. An intermediate levelunderstanding of value-based healthcare and population risk management is assumed on the part of the reader. 

Healthcare is an industry overrun with data but lacking in its ability to turn that data into information to drive  actionable decisions. This is due, in part, to the separation of physicians and healthcare providers, as  domain experts, from the decision makers who are driving outcomes-based healthcare. Third party payers are in the driver’s seat, dictating how medicine is practiced, with the onus of fulfillment resting squarely  on healthcare providers who traditionally have  inadequate digital tools to provide insight and therefore actions which produce desirable outcomes. For this reason, the United States averages only 8% to  15% fulfillment of needed preventative healthcare, driving healthcare costs ever higher while patient health  metrics continue to decline. 

Digital Decision Platforms 

DDPs provide easy-to-use tools for authoring decision logic with low-code and no-code techniques, allowing  business managers and domain knowledge experts to arrive at the best possible decisions. Without extensive  training or technical expertise, decision makers can manage both simple and complex decisions in a digital  platform that provides transparency and analytics for sensitivity analysis and outcomes management. 

Predictive analytics and machine learning (PAML) algorithms are typically employed to assess large quantities of  relevant data, identifying patterns and providing unique insights which are difficult, if not impossible, to do so at  scale in an analog manner. This supports rapid decision iterations, allowing measurement of performance  metrics, feedback intake, decision variable customization, and further testing and iteration until the desired  outcome is achieved. 

The DignifiHealth platform checks the box on each of these core functionalities of a top-tier DDP, allowing  healthcare providers and domain knowledgeable personnel the ability to affect change in the health of a  member population. 


DignifiHealth (DH) aims to democratize healthcare. Offering a seamless suite of healthcare solutions and health management technologies, DH reduces cost, saves time, and provides better experiences for patients, employers, providers, and payers. DH  

connects stakeholders on multiple sides of healthcare in an effort to better manage chronic conditions and improve health by  

engaging individuals under whatever title they may currently be carrying, be it patient, employee, health plan member, or other. 

All companies are healthcare companies whether they realize it or not. This is evidenced by the fact that most  company’s employee healthcare spend is among their highest expense items. DH offers insights and incentivizes  preventative care so that outcomes may be improved and costs may be lowered. 

DignifiEngage acts as the central hub of the DH platform and is the clinical intelligence and brain connecting the  data flows of all other DH platform products and offerings. Whether engaging DH via telehealth, remote patient  monitoring, activity tracking, or assessing gaps in your personal medical record, DignifiEngage uses real-time  predictive analytics and machine learning to offer care insights for personal health management as well as  population management. 

Focused on the healthcare supply chain and customer / patient impact, DH fulfills all the requirements of a DDP  and allows stakeholders of any skill level access to advanced business rule authoring, decision management,  predictive analytics and machine learning, and rapid decision iteration. 

Business Rule Authoring 

DH empowers healthcare providers of any technical experience to design and author advanced clinical  rule sets. Like InRule, discussed in the Forrester study, DH agrees that domain knowledge experts drive  better decisions, knowing the right questions to ask at the right time for the right outcome. 

With an intuitive yet powerful decision support engine, users can design rules and categories around  variables such as diagnosis codes, procedure codes, prescription therapies, lab results, vital sign  readings, and more. The user may also combine clinical indicators with demographics profiles, census  bureau variables, FDA classifications, and other available data sources. Stack and combine rules to make  advanced patient identifications well beyond the capabilities of Electronic Medical Records (EMR).

Rules can be used for patient identification and reporting or taken further and turned into real-time  patient flagging. Rules are triggered at every level of patient interaction, providing point-of-service  clinical insights, behind the scenes event triggering, direct patient engagement and intervention, and  confidence that data is being used to its fullest potential. 

Although the DH platform is conveniently pre-built with the rules and analytics needed to be successful  in any value-based payer contract, user creativity is the only limiting factor to what can further be  achieved in the DH decision support engine. 

Decision Management 

Building on the rules engine capabilities, the crushing administrative burden that accompanies today’s  value-based contracts is minimized if not alleviated with the DH platform. One of the largest gaps in  most health systems is the ability to identify risk. What patients need attention? Which patients are  going to arrive in my Emergency Department? What is the biggest care need for a group of patients?  These questions and many more leave systems working in an extremely manual fashion with lagging  payer data to comb through medical charts and identify gaps in care, all on a post-facto rather than  proactive basis. 

With DH, these questions are answered real-time in a few clicks of a button. In an intuitive and simple design, identify all patients with multiple chronic disease conditions, the typical 3.5% of patients who make up 50% of the risk, all diabetic patients who have not had a Hemoglobin A1c, and any number of other metrics tied to value-based payer contracts. 

Decision management is automated and any number of patient identification answers are at one’s  fingertips. Where many health systems today rely on personnel with database management or SQL reporting skills, who typically are not clinically minded, DH turns anyone in the organization into an  

advanced clinical report writer with minimal technical experience necessary, most importantly, on a  real-time rather than retrospective basis. 

Predictive Analytics & Machine Learning 

Like FICO identifies risk in the financial services industry, DH is doing so in healthcare. Where FICO may  review one’s compliance with monthly loan payments, DH reviews one’s compliance with evidence based preventative best practices. Where FICO identifies individuals out of balance in their leveraging of  debt, DH identifies individuals uncontrolled in their chronic disease management.

With DH, while users can build custom rules and make on-demand patient identifications, sophisticated machine learning (ML) algorithms are being constantly run in the background against the data, triggering event responses and actions which prompt users, providers, and even patients of needed interventions. Not only can these notifications be triggered real time, but they will also be made available to both provider and patient at the patient’s next scheduled care appointment, ensuring needed care does not slip through the cracks of a disjointed healthcare system. 

ML insights then put the full power of predictive analytics in the hands of providers, health systems, and  payers. The ability to identify pre-conditions like Chronic Heart Failure, Diabetes, COPD, and others  allows intervention to occur to mitigate, delay, or even prevent costly diagnosis and poor patient  outcomes. First class preventative care can be offered, producing better outcomes at significantly lower  costs. 

DH not only allows the ability to identify and estimate “what will happen” through predictive analytics,  but further provides tools for outreach and engagement, using prescriptive analytics to say “how can we  make it happen”. Turning hindsight into insight, DH provides the foresight to prompt needed  interactions and interventions with all healthcare stakeholders. 

Rapid Decision Iterations 

“What gets measured gets improved.” Typically attributed to Peter Drucker, this phrase has been widely accepted as obvious for

decades and has been fully embraced by healthcare administrative teams. The problem is, as V.F. Ridgway pointed out in 1956, “not everything that matters can be measured. Not everything that we can measure matters.” 

While they are important and have a place in management, healthcare administration has seen an  obsession with scorecards, validation matrices, stop light reports, and more, rarely stopping to ask tough  questions like, “What decisions am I actually making as a result of what this report shows me?”. 

DH aims to measure the right metrics at the right time for the right patients so that the right actions  may be taken for the right outcomes. Sort through the noise and see what is actionable at the point-of care. Further, DH offers full scorecard availability around quality and gap closure metrics, provider  performance, and more. Utilize internal peer benchmarking at the provider, specialty or department, 

and organization level, as well as Medicare cost and utilization benchmarks. Get insight into  performance with drill-down capability for immediate identification of opportunities, as well as the  detail needed to act for improvement. 

The Forrester Wave 

The Forrester Wave seeks to plot companies based on the identified strengths and weaknesses along two axes:  Strength of Offering and Strength of Strategy. A third variable, Market Presence, is used to represent relative  company size or intensity on the plot, with the plot grid and relative placing of each company determining  whether each is a market Challenger, Contender, Strong Performer, or Leader. 

Given that the full DH platform is pre-sales and is set to launch in the July / August 2021 time frame, market  presence presents a challenge for assessment. Using a subset of the scorecard evaluation metrics from the  Forrester model, the below will analyze the DH platform by utilizing beta client response, sales validation  response, and current / future technical capabilities. 

Strength of Offering 

Data Integration 

DH aims to accept data from any source in any format and will offer the ability to send data to  any destination in any format. With a vision of true interoperability, DH will draw data from  EMRs, payer claims data, pharmacy fill data, public Medicare and Medicaid data sets, FDA data,  US Census Bureau data, third-party healthcare software, wearable device data, remote patientmonitoring devices, and more. Data will be exchanged in flat file CSV format, HL7, FHIR, JSON,  CCD, XML, and more, offering the latest technological integrations while acknowledging that  most of the industry operates on legacy systems. DH will create a homogenous data lake  environment from which all PAML and automation will function. 

For beta customers of the DignifiEngage platform, data was able to be mapped and ingested  from EMRs in less than 60 days. DH aims to be a market leader in time to onboard, offering the  fastest route to customer ROI. 



The DH platform is described by beautiful simplicity, ease of use, and most impressively, speed.  While offering flashy visuals and scorecards which appeal to executive personnel, DH knows that  front line staff make up the bulk of the user base. DH is therefore unintimidating, intuitive, and  requires minimal training or technical ability to be able to utilize the platform to its fullest – all  while providing the latest in PAML and automation in the background, empowering healthcare  users at any level.

Built on a world-class fintech base, DH brings the sophistication of fintech into a much-needed healthtech application. From the ability to facilitate Health Reimbursement Accounts with a DH  credit card, to virtual wallets and incentivization of care, to offering banking functions like  provider loans, and a vision of real-time claims adjudication, the fintech underpinnings of the DH  platform extend the possible in any clinical setting. 

Feedback from beta customers of DignifiEngage, as well as sales validation engagements, has  been overwhelmingly positive. From seeing hospital Quality departments revolutionize their  workflow, to increasing provider clinic throughput, and more, it has been called “indispensable”,  “the missing link”, and “the best population health platform we have seen.” 

Strength of Strategy 

Ability to Execute 

After product, execution is the number one priority. DH knows that SaaS companies live or die  by their ability to execute with customer onboarding, account management, customer service,  and ongoing stickiness for contract renewal. For this reason, the very first high-level hires are  for these purposes. DH has further taken very strategic investment partners with vast account  

management experience which will enhance and guide the mechanisms needed for hyper  growth. 

Solution Roadmap 

DH provides solutions for providers, patients, employers, and payers. While individual pieces of  the DH platform can be found in the existing competitive marketplace, one is hard pressed to  find a platform that offers a “single pane of glass”, with telehealth, triage, clinical insights,  automation, risk stratification, remote patient monitoring, virtual wallet, chronic care  management, and so much more all accessible from a single cohesive platform and experience. 

Minimum Viable Product has been achieved with initial market reactions showing positive. The  DH web and portal platforms will be available in the July / August time frame, offering full  capabilities of telehealth, pharmacy benefit management, and clinical intelligence. The  remainder of 2021 will see the additions of remote patient monitoring and chronic care  management, while early 2022 sees the full capabilities of virtual wallet and gamification of  wellness care. 


As addressed throughout this analysis, DH empowers healthcare users at any level and in any  setting with clinical intelligence at the click of a button. As IBM and Tibco were described in the  Forrester study, DH offers automation at every turn and can ingest, analyze, decide, and act  upon patient data and events in real-time, standardizing processes so staff can focus on their  patients rather than administrative burdens. 

Bottlenecks in today’s healthcare operations include a lack of accessibility to advanced clinical  reporting, manual and lagging data insights as payer claims are awaited, and no visibility into 

where risk resides in a population. DH addresses each of these, enabling users to identify the  right care for the right patient at the right time. 


DH has built an impressive pipeline, gaining traction in conversations and partnerships with  state Health Information Exchanges (HIE), primary care associations, clinically integrated  networks, Accountable Care Organizations (ACO), Clinically Integrated Networks (CIN), and  more. On the employer side, DH has signed engagements with national benefits brokers,  offering a suite of employer benefit options to millions of accessible employee and member  lives. With single digit percentage penetration into existing pipeline deals, DH more than  achieves initial three-year financial projections. 

Market Presence 

Market Awareness 

DH has a unique insight into market awareness and needs. The founding team of DH brings  many decades of combined healthcare experience across all aspects of the healthcare spectrum,  from providers, to payers, to administration, to mergers and acquisitions, to healthcare sales,  the DH team began careers as customers who experienced the struggles and barriers present in  today’s healthcare workflow. Seeing firsthand the inefficiencies and crushing administrative  overhead burdens of trying to offer first-class patient care, the DH team knew there was a  better way. 

DH sets out to be missionaries rather than mercenaries. With a vision of the democratization of  healthcare, DH is driven to offer a holistic approach to a siloed industry, better experiences for burned-out providers, better outcomes for struggling patients, and true value through lower  costs for all healthcare stakeholders.

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