The Importance of Disease Specific Follow-Up

When patients are in the hospital, their care is tailored based upon their unique needs and specific disease. They will receive a different treatment plan, medications, and discharge instructions based upon the criteria designated for their medical history and disease. When a patient leaves the hospital, their follow-up should also be disease specific and unique to their needs.

Disease specific questions, multiple language options, and personalized discharge instructions are all ways in which hospitals can most effectively reach and monitor each patient. This improves patient outcomes, reach rates, and satisfaction while reducing readmission rates and penalties.

Disease Specific Questions

When following up with patients it is important to capture a variety of clinical and satisfaction data. Although many questions will be similar regardless of the patient such as, “did you understand your discharge instructions?” It is also necessary to have questions that help identify patients at risk for readmission based upon their specific disease.

For example, a patient recently discharged for pneumonia will need to be asked if they are experiencing shortness of breath; however, a CHF patient will need to be asked about whether or not they have gained two or more pounds in a day since being discharged.

These questions evolve with each call post-discharge. For instance on a first call patients will need to identify whether or not they were even able to fill prescriptions, but on subsequent calls they will need to identify whether or not they have been taking their medications. Tailoring to diseases and knowing what questions to ask when better identifies patients who need help in ensuring they are not readmitted to the hospital.

Multiple Language Options

Each patient population is unique, and a big challenge for many patients is understanding how to care for themselves outside the hospital. Inside the hospital, interpreters and family members help to bridge language barriers, but having these options for patient follow-up is not always common practice.

When reaching out to patient’s post-discharge, ensuring they have the ability to listen to and answer questions in the language best suited to them will effectively foster higher reach rates and more accurate data reporting.

Personalized Discharge Instructions

When patients are being discharged from the hospital they tend to be more focused on getting home than listening to all of the instructions needed to get better. Having a way to personalize this process such as individualized recordings can help patients better care for themselves.

Once patients are home from the hospital, they can listen to their own recording and take the time to comprehend how to avoid readmission. These recordings can be done with the patient and if needed, an interpreter – giving the best chance of discharge instruction adherence.

Ensuring that patient follow-up programs have disease specific questions, multiple language options, and personalized discharge instructions help to tailor the post-discharge program to the patient. This personalization and care will go a long way in showing patients that their care matters even when outside of the hospital. It will also create better outcomes for each patient and help to reduce preventable readmissions.

To learn more about how to personalize your patient follow-up program, click here.

CipherHealth empowers providers across the care continuum to deliver enhanced patient experiences and communications through a modular, comprehensive patient engagement technology platform.