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Risk Stratification

Within a fully integrated health and social care system, Graphnet occupies a unique position to support organisations to undertake risk stratification, impactibility monitoring and utilise real time intelligence to support patient care.

Our solutions bring together a large variety of information into a centralised location enable effective and automatic modelling. Benefits include:

  • From risk stratification to prevention: Our full end-to-end solution enables the identification, classification and prevention of care deficits. Risk stratification engines can be integrated to enable the early detection of patients at risk or those who have negative health trajectories. Automated ‘what-if’ models can give clinicians lists of preventive and reactive models driven by data and evidence.
  • Cohort mapping engine build localised registries: The cohort mapping engine delivers standardised diseases and wellness registries. The engine also gives users the ability to include their own mappings which enables localisation.
  • Frailty: The electronic frailty index (eFI) delivers the ability to stratify the entire elderly population. Frailty deficits are calculated and a full history for each patient can be analysed. Graphnet is working with a leading university on the development of advanced artificial intelligence to predict the future frailty state for a population.  
  • Data and model APIs: Our APIs allow the integration of our business intelligence and data science packages with third party tools, and vice versa. Following the REST API structure means that our APIs enable easy to use industry standard integration with third party applications.

More patient-centred diabetes care in Wolverhampton

Wolverhampton CCG chose CareCentric as its partner to create a seamless diabetic service across all healthcare providers and the local authority, delivering more efficient and patient-centred care.

As well as using CareCentric to bring together data from multiple sources, Wolverhampton CCG is using business intelligence to analyse and risk stratify data collected and combined from GP practices and the NHS Trust.

Business intelligence is used to apply local algorithms across all interfaced data, analyse and display the data in dashboards. This enables targeted care across all providers.

A key differentiator is that the data is a combination of real time (acute feeds) and daily feeds for GP and other data. This means that risk stratification and impactibility monitoring can be done daily. The results displayed as part of the patients integrated care record as decision support for clinicians and other end users.


“By working with Graphnet, we have been able to convert the information we have available to us into a rich asset which informs the delivery of more efficient and focused services.”

Mike Hastings, Head of Business and Performance Management at Wolverhampton CCG