A CipherHealth Community Forum: Utilizing CipherOutreach for Post-Discharge Follow Up Best Practices

As a member of the CipherHealth community, there are many benefits, one of which is learning from other members across the country. One regular aspect of this is our user forum webinar series. During these webinars, providers learn from each other by sharing learnings and best practices on implementing technology.

Recently, two organizations shared their outstanding work in implementing and leveraging Voice, CipherHealths patient outreach platform. During the webinar, Alicia Yang, Senior Account Strategist at CipherHealth provided an overview of how Voice works for post-discharge follow up and identified our best practices that can help organizations succeed when implementing Voice.

The webinar then focused on two clients and their learnings from using Voice, Sentara Williamsburg Regional Medical Center and Baptist Healthcare in Montgomery, AL.

Sentara’s Centralized Escalation Process

    • Catherine Smith, DNP, RN, CCRN, CCNS, Professional Practice Manager and Magnet Coordinator for Sentara Williamsburg Regional Medical Center, described how Sentara piloted the Voice product in three sites, focusing on patients with a high risk of readmission and then expanded to all 12 hospitals upon seeing the success of the program.

Unique to the Sentara program is the centralized call back system that has a tiered escalation process. The nurses in the centralized call system resolve about 80% of all issues after talking with the patient and reviewing the medical record. If they are unable to resolve the issue, it is escalated to the site contact who quickly reaches out to the patient. The third escalation tier is to the Integrated Care Management program which marshals resources such as pharmacy, care manager, and the patient advocate.

Through the use of scripts customized for specific patient populations, Sentara Williamsburg has seen a statistically significant reduction in its readmissions, demonstrating the impact of the Voice touch point and the follow-up from a clinical nurse.

Baptist’s Data-Based Action Plans

    • Kelly Benson, RN, the Director of Community Care Management for Baptist Health Center for Wellbeing in Montgomery, AL. provided an overview of their partnership with Team Health physicians. The physician group realized the benefit of using the Voice technology for patient follow-up and partnered with Baptist Health’s Center for WellBeing which supports its three hospitals.

After implementing Voice, the team reviewed the data and found that 80% of all the identified issues are social concerns. As a result, the Center for Wellbeing utilizes the skills of a social worker as the first responder for those patients needing additional outreach.

The results demonstrate a reduction in readmissions for both the general inpatient and patients with Chronic Obstructive Pulmonary Disease (COPD). This is due to timely problem resolution aimed at helping the patient obtain prescriptions and helping patients navigate the healthcare system.

The user forum webinars are a great resource for our clients who want to learn about and adopt best practices. As outlined by Smith and Benson, Voice can be tailored to meet the goals of your organization and provides immense benefits through issue resolution and actionable insight. Contact us today for more information on our user forum webinars or how to implement a successful post-discharge follow-up program.

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