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Community-based health coaches and care coordinators reduce readmissions using information technology to identify and support at-risk Medicare patients after discharge.
Agency for Healthcare Research and Quality. Health Care Innovations Exchange. July 30, 2014.
This article describes an intervention that trained health coaches to use mobile technology to assess the health status of recently discharged Medicare patients, first during an in-home visit 48 hours after leaving the hospital and then with weekly phone calls over a 3-week period. The program resulted in decreased readmission rates and significant cost savings.
Journal Article > Study
Dykes PC, Carroll DL, Hurley A, et al. JAMA. 2010;304:1912-1918.
Patient falls are among the preventable complications of hospital care for which hospitals no longer receive additional reimbursement from the Centers for Medicare and Medicaid Services. Experts in the field have questioned the wisdom of this policy; even though falls are common, little evidence has been available to guide fall prevention strategies. This randomized controlled trial offers an advance in fall prevention, as it demonstrated a significant reduction in falls by using a customized fall prevention strategy. The study also represents a novel application of information technology to improve patient safety, as the patient-specific fall prevention toolkit was developed with a novel software application drawing from the electronic medical record.