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Ankota: Home Care Next Generation Blog

Hospital to Home Focus Reduces Readmissions

NBC News Health Readmissions

Ankota develops technology that is used to coordinate care that is delivered outside of hospital settings, often in follow up to a hospitalization. The hospitals, ACOs, and home health agencies we talk to ask us to point them to evidence that these Care Transitions efforts really work. They don't doubt that it works - they simply need as much evidence as possible to help garner support in their own organizations. "Fuel to the fire," if you will

Manage Population Health Models with software from Ankota

In fact, the people we engage with are usually the champions for such causes in their organizations. They simply have to find as many examples as possible that illustrate that care following discharge lowers readmissions and improves patients' lives...measurably. Examples abound as these models are gaining more traction for a number of reasons. So, it is in this spirit of sharing, that I re-run this post from NBC News Health that discusses a model in North Carolina that reduced avoidable readmissions by 20%.

Managing Care Transitions from Hospital to home reduces readmissions, study finds

In the study, researchers found that implementing a statewide transitional care program for Medicaid patients in North Carolina netted a 20 percent reduction in rehospitalization during the following year.

"That finding is fairly consistent with what had been shown in other studies… We were hoping to achieve that big of a difference. The novelty was being able to achieve it on this scale," Dr. Annette DuBard, the study's lead author from Community Care of North Carolina in Raleigh, told Reuters Health. 

Care Transitions Technology from Ankota

Professoinals have long known intuitively that the most critical time for a patient is the first hours or days immediately following discharge. Their ability--or inability--to get prescriptions filled or access transportation to and from follow up visits makes them especially vulnerable. Sometimes the state of the home or lack of support from immediate family members also plays a role. More studies are addressing these issues to make sure that patients receive adequate and timely follow up care, and measuring results. Some use home care providers to assist with adapting to life back in the home. It's even been found that a home inspection can mitigate potentially dangerous situations such an area rug that might increase the patient's risk of falling.

Programs such as this one in North Carolina and many others are demonstrating that with focus on some of these issues, the rate at which patients are readmitted to the hospital can be measurably reduced. This study in North Carolina is especially interesting because it reflects a larger scale. Many have wondered whether some care transitions programs can scale across larger populations while maintaining the impressive reductions in readmissions that we've seen. Admittedly, most programs have been administered manually and have only begun to examine what is actually possible. Through better use of technologies like Ankota's, providers can manage much larger populations more cost effectively and measure success along the way.  

Contact us to learn more about how Ankota technology is used to organize and manage population health projects like this, and how post acute partners are being leveraged to deliver better care, more efficiently.


Manage Population Health Models with software from Ankota

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