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Post Discharge Follow Up Reduce Hospital Readmissions

Think Automated Post-Visit Calls Reduce Readmissions? Think Again.

Think Automated Calls Will Reduce Readmissions? <!--more-->Think Again.By now you understand that timely follow up, evaluation, and coaching are critical to managing patient health after discharge.

So the question becomes, which follow up strategy is best for you and your patients?

One option that's gaining popularity recently (namely because of its price) is to use automated outreach calls – a.k.a robot calls.

In short, this option is very likely a bad idea. 

This isn't to say you shouldn't use them at all. Automated outreach calls are an important part of your communication toolkit – one that you should absolutely use within your population health strategy.

You just shouldn't use them for post discharge follow up.

And here's why.

Every Single Post-Visit Follow Up Call is a Clinical Call

No exceptions. 

With all the talk around service recovery, survey scripts, engagement rates, and the like, it's easy to lose perspective and begin thinking that these are customer service calls. 

Adding to the confusion is the fact that in some cases a non-clinician is making the initial outreach – which is a common call-flow for many outpatient follow up programs.

Not to mention the emphasis placed on improving patient satisfaction (a common phrase in marketing).

It's easy to see why folks get the wrong idea and think cheaper automated calls are an adequate substitute for human follow up. The problem is that the patients you're calling aren't in optimal health, making it more likely they'll require clinical support – support that needs to be provided at a moments notice.

There needs to be a reliable way to escalate patients to the appropriate clinical resource.

Why a Person is Needed to Ensure Appropriate Escalation

Yes. Automated Voice Services have become quite sophisticated.

In fact, to address the clinical escalation issue, many automated solutions allow patients to request a live agent at any point during the call. When a patient initiates this verbal command, the software triggers an automatic transfer to the appropriate staff member, such as a nurse.

The reason why this isn't acceptable for post-visit follow up is that it assumes patients will realize they require clinical help, and then take action – which experience has taught us isn't always the case. 

Here's an example.

Recently, one of our Transition Specialists, Jon (a non-clinician), was following up with a patient who had been discharged from the Emergency Department the day before.

As Jon went through the post discharge survey, he noticed that the patient was having difficulty breathing. Based on the escalation rules built into the program, Jon paused the survey and asked the patient if he would like to speak with a nurse. 

Despite his labored breathing, the patient indicated that he was fine. 

When Jon moved on to the next survey question, it was obvious that the patient's breathing was getting worse, to the point where it was difficult for him to speak. Following his training, and using his own judgment, Jon immediately escalated the patient to a nurse.

If this had been an automated call, the survey would have continued without interruption or escalation. 

The (Mistaken) Case for Using Automated Post-Visit Calls

The value proposition for many Automated Voice Service vendors is centered around cost.

Specifically, that without using cheaper automation, healthcare organizations like yours would be unable to reach every discharged patient due to the expense associated with providing one-on-one care. They go on to postulate that not all patients recently discharged from the hospital require intervention by a healthcare professional and that any type of 'connection' will be enough.

Clearly, lack of funding and/or budget priority is a significant challenge to providing appropriate care.

However, as we discussed above, the primary purpose of discharge calling is to not merely 'connect' with the patient in order to conduct a survey. Rather, it's to provide immediate clinical support that will catch health issues early, before they have a chance to progress into conditions that require readmissions.

Further, basing your decision on price takes emphasis away from what really counts – quality patient interactions. Sacrificing quality in the pursuit of a slightly cheaper service will undoubtedly reduce the likelihood you'll be able to impact readmissions enough to avoid CMS financial penalties. 

When You Should Use Automated Voice Services 

Even though Automated Voice Services are not an appropriate solution for post-visit follow up care, that's not to say you shouldn't use them as part of your transitional care program. 

In fact, when used in conjunction with staff based discharge calling, these automated solutions can be highly effective at driving patients to use healthcare resources appropriately. 

Some examples include (but are not limited to):

  • Appointment reminders.
  • Proactive / overdue refill reminders.
  • Preventive care messages.
  • Drive to action (e.g. registering for event, enroll in care management, etc.)
  • Physician-to-Physician notifications.

As you develop your transitional care programs, pay careful attention to when you utilize automated calls. Even the most sophisticated technology can't replace human experience, empathy, and caring.

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