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Repisodic Blog

Sharing insights, impact and successes in our mission to help health systems discharge every patient.

Using Technology to Help High-Risk Patients Achieve Successful Care Transitions


As advances in health information technology continue to promote equitable healthcare, hospital patients across demographics are benefiting from higher quality care transitions at discharge and positive individual health outcomes.

Transitioning a patient from an acute care hospital to a post-acute care (PAC) or other post-discharge care provider is a critical step in the patient recovery journey, especially among vulnerable, at-risk patients. Studies show that patients achieve more positive health outcomes overall when the transition and transfer of patient information out of the hospital is done accurately and efficiently. Inefficient transitions result in the loss of critical medical information, increase the risk of medical errors, raise costs, and decrease patients’ abilities to care for themselves. For patients of low socioeconomic status and with high-risk conditions, preventing these negative outcomes is crucial. To avoid inefficient and poorly managed care transitions, The National Academy of Medicine suggests that more hospitals and post-acute care providers utilize communal, technology-based systems that ensure the timely and accurate communication of patient information: systems like Repisodic.

From a patient perspective, hospital discharges and transitions of care are often stressful and tedious for patients and their loved ones, especially if they’re experiencing financial hardships or facing serious illness or injury. Patients already feel vulnerable leaving the hospital, and uncertainty over their post-acute care only heightens anxiety. Taking control of the hospital discharge process alleviates anxiety for families and patients as they feel more confident in their decisions for post-acute care. Families are often burdened with the overwhelming, emotional challenge of researching and coordinating their relatives’ care when they leave the hospital. With technology that efficiently matches patients with the best options for post-acute care, families can focus on supporting their loved ones as they are transferred out of the hospital.

Advances in health information technology that streamline transitions of care have improved critical early intervention and communication in healthcare settings and allowed for greater continuity of care. By accurately maintaining, accessing, and updating medical data, EHR embedded IT platforms can improve a health system’s quality and control costs while also promoting equitable care for vulnerable populations. Implementing health IT that allows patients to take control of the discharge process also decreases the probability of patients facing multiple, avoidable transitions between PAC providers and other levels of care. When patients choose from accurate, data-driven lists of providers that match their needs, there is a greater chance that they will have a quicker and more successful care transition. Built-in technology features such as bed-availability alerts can provide vital communication between hospitals and post-acute care providers; patients and their families save time, energy, and strenuous patient transfers by knowing which providers have capacity to accept the patient before leaving the hospital. The ability for PAC providers to update their information in real-time is also valuable, especially in the age of COVID-19. Patients across all demographics can feel safer transitioning out of the hospital knowing they chose a provider based on accurate data.

Developments in health IT and interoperability continue to improve critical processes and workflows in health care. New features and advancements in health data exchanges through standardized FHIR and APIs have helped patients achieve more successful care transitions and better health outcomes. With technology platforms like Repisodic bridging the gap between hospitals, patients and post-acute care providers for transitions of care, we’re continuing to lead the way in helping hospitals discharge every patient, especially those who are high-risk and among the vulnerable patient population.