How mobile digital health systems can help
Regardless of the future for the Affordable Care Act (ACA), care managers are working tirelessly to enable ongoing, post-discharge, care plans to extend beyond the walls of the hospital. This is especially challenging when discharged patients have high levels of acuity and multiple, chronic conditions. These patients are likely candidates for patient readmission within weeks of discharge.
Capturing discharge information and physician orders (often referred to as After Visit Summaries) for easy interaction with patients requires a simple-to-use mobile application. But these “simple” apps involve sophisticated, custom interoperability between the patient, the EMR, and other systems like pharmacies that can be inside or out of the hospital or clinic.
Managing drug regimens for patients with multiple, chronic conditions can involve coordination of 10, 12 or even more medications. Their care plans need to work closely with pharmacy professionals to:
- Resolve any conflicts between new drugs added during hospital admission with previously prescribed medications
- Track and manage fulfillment of new medications along with refills of existing ones
- Communicate with patient as well as hospital pharmacists
- Enable a pictorial pill box with timing, dosage and physical appearance of prescribed medications
Specialist care providers often engage with chronically ill patients after discharge on their individual treatment plans. Tracking visit outcome, additional follow-up, and interoperability between specialists’ and hospital systems is an on-going challenge. Add changes or additions to doctors’ orders and you can see the potential for key information to fall through the cracks.
One of the biggest, and as yet unsolved, challenges facing patient readmission management is expanding coordination and connectivity to include the broad network of care providers beyond the hospital. These networks can include skilled nursing facilities, behavioral health care, community services, and home health and tele-health services.
Coherent Solutions is leveraging its mobile app experience in healthcare and other industries to help solve these challenges. Bridging these gaps with connected mobile apps will provide the comprehensive view of patients with chronic conditions needed to successfully reduce the risk of new events that could cause readmission to the hospital. In fact, you can read about some of our mobile app successes here: https://csidev.workwithwire.com/success-stories/