Nurture Your Discharged Patients With Analytics To Understand Who Needs Your Care Again

January 26, 2017

patient analytics.pngWhat If we told you that nearly 300 patents you’ve discharged in the last 9 months will soon need your care again? (Dive deeper into this metric by checking out this case study.) Medalogix Nurture will help you understand which ones, so you can be there to give them the additional home health care they need.

Medalogix Nurture is our predictive analytics solution that enables home health operators to engage with discharged patients who could benefit from additional episodes of care. Many leverage it to implement, streamline, augment or replace a post-discharged patient calling programs.

Cyndi_Rizzitello.jpgCyndi Rizzitello, RN, our SVP of client experience, who is herself, an experienced home healthcare nurse, will share some examples of how both large and small home health agencies leverage Nurture to improve care and operational efficiencies.

Why do agencies decide to use Medalogix Nurture?

Any decline after discharge leaves patients, agencies and referral sources at risk, especially so when this decline leads to  emergent or inpatient care. And further, if your agency is not aware of the decline, how can you act to prevent an adverse event? This leaves former patients at with a higher chance of a visit to the Emergency Department or being picked up by a competing agency!  

Many agencies have adopted post-discharge calling programs whereby in-office callers contact patients at pre-determined days post home health discharge to:

  • Provide an opportunity to discuss patient satisfaction in advance of the HHCAHPS survey
  • Allow for decline monitoring so that additional care needs can be triaged
  • Provide the opportunity to stay connected with their entire patient population

These are important benefits to the patient and agency but the task itself, by virtue of sheer volume and time, is usually unmanageable.

Medalogix offers a better strategy that home health agencies of all sizes can deploy.

By tapping into the benefits of predictive analytics, Medalogix Nurture can tell you which patients to call and when. This happens through the magic of data science, where OASIS and other EMR data is modeled. Then, based on past-patterns of patient acuity and readmissions, patients are ranked according to their risk. Your post-discharge calling team now knows which patients need to be called sooner than later, while still ensuring all patients, regardless of risk level, are eligible to be tracked and called.

Top home health agencies deploy Nurture to ensure they have a streamlined and effective approach to best care for their patients—even after discharge.

How has Nurture changed discharge care planning?

It adds prioritization, objectivity and process to how a home health agency cares for its former patients.

How has Nurture benefited home health organizations like Jordan Health Services and Encompass?

In April of 2016, Encompass began using Nurture in nine home health branches. While they had an existing discharge calling program in place prior to Nurture, they’ve experienced significant improvements, like:

  • New admission generation: In the first nine months of use, Nurture has facilitated more than 5,000 patient contacts, resulting in identification of 276 patients in need of home care.
  • Earlier identification of customer service-related issues: Post-discharge calls give patients the opportunity to discuss their level of satisfaction with the care provided by Encompass. It also presents the opportunity to clarify or intervene on any issues that were unresolved prior to discharge, before the patient has been presented with a satisfaction survey.
  • Assurance that the right patients are being called at the right time: Since the Nurture risk stratification groups patients according to their potential to need additional care, Encompass was able to quickly act on those patients at highest risk post-discharge while waiting longer to call all others. This has allowed for better resource management and earlier identification of those most in need.
  • Ease of managing and tracking calls: Because Nurture has a built-in scheduling and follow up system, Encompass can easily manage which patients have already been called, which of those need additional calls and which need referral to home health or other levels of care.

“Nurture has helped us become more efficient by narrowing our focus on high risk patients who may benefit from touchpoints after discharge. Patient care does not stop once discharge has occurred. By quickly identifying patients through the Nurture risk stratification, we are able to intervene at different milestones to mitigate avoidable emergent care situations and provide the right care at the right time.”


Stay Up-to-Date on the Latest News, Events and Resources!

Sign-up to receive timely industry updates, helpful articles, live and on-demand webinars, and much more – all delivered directly to your inbox.