Care Coordination & Transition

The transition from one care setting to the next is a vulnerable time for any patient. The care patients receive after a hospital stay is often fragmented. Care plans can be conflicting; services, duplicated; and medications, unreconciled. The result? Higher-cost, lower-quality care—and sicker patients who often land back in the hospital in less than a month.

TRANSITIONING PATIENTS BETWEEN HEALTHCARE SETTINGS CAN YIELD GAPS IN CARE, COMPROMISING SAFETY, QUALITY, AND CLINICAL OUTCOMES.

 
 
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Triage and workflows

Patient lifecycle and daily engagement technology that improves care transitions by:

Digitally passing discharged patients into remote monitoring triage and workflow, using integrated orders coming from the electronic medical record. Combining monitoring and appropriate escalation protocols to ensure care continuity and earlier interventions for patients.


A robust and extensible platform, integrating multiple engagement and remote care programs for optimum patient care management.

Streamline the patient experience of the post-acute care plan, conveying clear care instructions and needed follow-up activities, while giving patients, primary care physicians, and specialty providers ready access to the patient’s well being at all times. Mitigate financial risk for the healthcare organization while generating improved clinical outcomes for “win-win” provider and patient alignment.

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Post-Accute Care value:

Gain efficiencies in clinician workflow by reducing phone calls and in-home visits. Avoid preventable hospitalization expenses and/or readmission penalties. Regular virtual visits help care teams identify and fix social health and safety issues. Reduce length of stay with provider confidence. Engage and educate patients and families to ensure compliance with care pathways.