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Keeping Patients Engaged: How Advocate Health used patient-centered outreach to close care gaps

Aah Care Gaps Blog

For many people, coordinating their own healthcare can be difficult, particularly after a long lapse in seeking out preventative care, services, and other screenings. Advocate Health, a healthcare provider serving patients across multiple states, has implemented CipherHealth’s outreach technology to simplify the scheduling process for its patients, and particularly high-risk populations. By leveraging automation for patient outreach, Advocate Health can ensure more of them receive the care they need when they need it, minimizing unnecessary emergency room visits and hospital admissions and closing important care gaps.

An innovative approach to patient engagement and continuity of care

The goal: Advocate Health wanted to reach patients who had care gaps to schedule a comprehensive visit and, for high-risk patients, a health exam. But the large volume of manual phone calls quickly became labor intensive and limiting insofar as the amount of patients they could reach. Although their staff was able to place 19,000 calls, this was only a small subset of their patients.

The solution: a multi-faceted approach to care gap closure that combined voice calls, SMS text messaging, and call-back options to significantly increase patient engagement. Leveraging CipherHealth’s platform, Advocate Health managed to triple their patient outreach efforts. In the first ten months of 2023 alone, Advocate Health contacted over 57,000 patients, compared to 19,000 the year before.

By incorporating automated phone calls and text messaging for care coordination, patients were provided with direct links and buttons to easily schedule appointments, enhancing accessibility. CipherHealth’s automated outreach capabilities also allowed patients the option to live-transfer to Advocate Health’s team to help with scheduling or request a call back that was more convenient for them.

A key feature of the technology was the call-back option, which meant the system would reach out to patients again during their preferred times. This could help prevent patient attrition and increase the odds the care gaps get closed, increasing patient loyalty and ultimately improving health outcomes.

Results and impact of care gap closure

With the help of automation, Advocate Health not only enhanced efficiency for both staff and patients but also significantly expanded its reach. With automated outreach technology in place of manual calls by staff, Advocate turned new connections with patients into 2,632 actual scheduled appointments. Additionally, the effort led to:

  • A 200% increase in patient contacts
  • 851 reevaluated chronic conditions
  • 974 newly flagged chronic conditions
  • 1,654 medication orders placed
  • 874 patients reconnected to a primary care provider 

Advocate Health uses CipherHealth for additional programs, including a Medicare Wellness Visit (MWVs) campaign. In 2023, outreach to over 134,000 patients helped achieve a 7% increase in completed and scheduled Wellness Visits across the system compared to 2022.


CipherHealth’s patient engagement tools supported Advocate Health’s goal of acting as a safety net, ensuring patients receive the preventive care necessary for maintaining their health. It helped streamline the scheduling process for high-risk patients and empowered them to take charge of their own care. By closing care gaps through increased engagement and personalized outreach, the health system could improve patient outcomes and value-based care delivery.


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