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Post-Discharge Protocols


Disease-specific monitoring/flowchart to reduce re-admissions. Hybrid automated/manual – automate monitoring while all is well (most patients) but dispatch to human case manager when needed.

Disease-specific monitoring/flowchart to reduce re-admissions. Hybrid automated/manual – automate monitoring while all is well (most patients) but dispatch to human case manager when needed.

Case Management Gaps

Think outside the building. Interact with patients before & after their stay to ensure they are getting their meds, staying healthy, and keeping up-to-date. Address issues & questions before they become problems.

Drug Adherence

Confirm prescriptions got filled & notify provider if not.
  • Improve outcomes
  • Improve retail pharmacy revenue

Make Intelligence Actionable

Apply case management communication protocols to patients flagged by AI tools as likely to have future problems.
  • Automate actionable efforts from AI results
  • Close the loop on cohort analysis

Rehab/Recovery

Send rehab/procedure recovery information coordinated with the patient’s recovery schedule.
  • Improve outcomes
  • Prevent further injury

Results Notification

Send a secure link to procedure results as soon as they become available.
  • Promote ownership of health
  • Promote portal activation and utilization
  • Reduce staff phone calls

Wellness Reminders

Notify patients when due for annual checkup.
  • Improve population health
  • Automate wellness monitoring
  • Improve access and revenue

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