Specialty Referral Optimization

Leveraging AI & machine learning allows us to prioritize which patients to contact first based on their predicted

utilization patterns, potential for necessary downstream procedures, and the increased need for specialty care. Through prioritized engagement and outreach, 90% of patients needing a new PCP are getting their next appointment scheduled within seven days of discharge. 

By prioritizing the patients with greatest need, we’ve seen a 25% reduction in median time to appointment for new specialist relationships. Patients with the highest likelihood of needing downstream high-margin procedures were all seen within 14 days of discharge.

Streamlining how we priortize patients for navigation also results in improvements in throughput and capacity. By applying smarter, iterative models, one client has seen a 90%

growth in patient visits (and double the profit margin), 142% more visits than would have occurred without navigator intervention and 3x the volume of same day surgeries, resulting in an increase in higher margin procedures.

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.