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ED Post-Discharge Patient Navigation

ED Post-Discharge Patient Navigation

ED Post-Discharge Patient Navigation

5 verified clients
ED Post-Discharge Patient Navigation
ED Post-Discharge Patient Navigation


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Avia Summary

ED Post-Discharge Patient Navigation is a solution provided by Care Continuity which was founded in 2008. It belongs to multiple categories of digital health solutions including Care Transitions, Referral Management, Concierge Care, Personalized Care, Conversational AI, and Smart Hospitals.
It has 5 verified clients.
ED Post-Discharge Patient Navigation integrates with major EMRs such as Epic, Cerner, and Meditech.
Some other resource(s) that may be helpful in learning about ED Post-Discharge Patient Navigation include: Mytonomy guide: Selecting a Modern Enterprise Patient Education Solution and A buyer’s guide to conversational AI

Care Continuity's ED-Post Discharge Patient Navigation program is a data-driven patient navigation service designed to reduce patient outmigration and grow profitable service lines. 

Care Continuity leverages a purpose-built software that utilizes AI and machine learning to analyze dozens of data points and social determinants of care that make it possible to prioritize patients for outreach based on their need, and to maximize the downstream effectiveness of a patient navigation program. In addition, the software is supported by a team of trained concierges that do the navigating on your behalf, allowing your team to continue working at the top of their license.

With the ED Post-Discharge solution, Care Continuity drive 12 - 15% service line growth while reducing unnecessary ED returns by an average of 33%. 

Care Continuity's team of specially-trained patient navigators are dedicated to providing the best experience for every patient, leading to increased patient satisfaction and loyalty.

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Product capabilities


Care Continuity's software solution support bi-directional integration with the ability to ingest applicable data from a health system's EHR, as well as repopulate any applicable system post-navigation.

What is interoperability?
Conversational AI solutions should seamlessly integrate with the EHR and other existing systems, databases, and digital channels.
EHR integration

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform
Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson
Not applicable
Use cases and differentiators

A health system located in a large metropolitan area with other large health systems is competing to capture and retain patients. One of the key entry points for this health system is their emergency department locations. However, after discharge, they are seeing a large percentage of patients seeking prescribed follow-up care at non-network aligned facilities. In addition, they are dissatisfied with the amount of ED readmissions due to lack of timely follow-up care. 

Leveraging Care Continuity's ED Post-Discharge Patient Navigation solution, a data feed is sent to Care Continuity where the software's AI uses dozens of data points -- including diagnoses, discharge notes, patient information, social determinants of health, and more -- as well as a set of customizable prioritization rules to create a navigation queue for a team of expert navigators to personally contact and navigate. 

This allows for a multi-dimensional approach to patient navigation that can predict which patients are most in need of, as well as open to, navigational assistance. 

As a result, the health system sees a reduction in post-ED outmigration to competitor facilities. Discharged patients are 83% more likely to receive in-network follow-up care, and ED readmissions are reduced by 33%. This leads to an average ROI of 4:1 within 120 days of program launch. 

Medium to extra-large health systems

Leading EHR functionality takes a very basic approach to patient navigation. When utilized, the EHR prioritization queue is binary, labeling every patient as urgent or non-urgent. Instead, Care Continuity not only expands the total number of evaluated data points needed to properly prioritize a patient, but Care Continuity also expands the priority listing to 10 levels, allowing for a more nuanced and tailored navigational experience. 

In addition, the EHR functionality requires the health system to staff a team of navigators. Unfortunately, this largely non-clinical function is staffed by clinical staff, severely hampering their ability to work at the top of their license. 

Care Continuity pairs their purpose-built software with a team of trained, non-clinical concierges who are experts in patient experience and proper navigation.

With more than a decade of experience working with the nation's leading health systems, Care Continuity has had the honor of navigating millions of patients through the healthcare continuum. 

Leveraging purpose-built software with proprietary algorithms designed to efficiently navigation patients, Care Continuity can provide a customizable, high-ROI solution for health systems of any size.

Company information

Founded in 2008



Post-Discharge ED Follow-Ups
One-Size-Fits-All Patient Navigation
In-Network Follow-Up Care
ROI-Minded Approach
Readmission Decrease
Prevent Leakage with AI

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