Smart Assistant to Reduce Post-Discharge Readmissions

Post-discharge readmission among Medicare patients:- 19.6% readmitted within 30 days
– 34.0% readmitted within 90 days
– Costing $17.4 billion annually

Research also indicates that up to 40% of all medication errors can be traced back to insufficient medication reconciliation during the transition of care (source).

Notably, patient discharge planning is a legally mandated function for all hospitals in the United States.

The complex process of transferring a patient from one care setting (e.g., a hospital or nursing facility) to another often leads to confusion about treatment plans, missed follow-up appointments, patient dissatisfaction, and non-adherence to medication schedules. These causes result in unnecessary readmissions.

When patients become more informed and start to feel like part of the care team, they feel comfortable asking questions, raising their concerns, and proactively taking up their post-discharge duties. This is a simple solution to provide patients with more meaningful interactions while building deeper relationships, establishing trust, and ultimately establishing their commitment to better health in the long run.

Designing a centralized, digital platform that brings together all participants involved in post-discharge care that engages and supports patients through their entire healthcare journey.

Effective discharge planning is key to limiting medical errors during transitions of care from hospital to home – a time during which patients are particularly vulnerable. The ideal scenario for effective care involves the patient and emphasizes their complete education and active participation.

At Koru, our design process focuses on improving usability, accessibility, and delight in product interactions. Keeping the user in the center of the creative process leads us to create designs that are clutter-free, easy, intuitive, scalable, engaging, and provide a fabulous experience to the users.

The research phase of the process began with in-depth data gathering. We started by conducting user interviews. This, along with periodic consultations with stakeholders helped collate information that helped in forming user personas and a typical patient journey map.

Ensuring active patient participation in their post-discharge care requires an ecosystem that facilitates building a relationship of trust and seamless communication amongst all three participants, i.e., the patient, clinician, and admin. The process begins with addressing their combined essential needs.

Ideation

Regular and efficient post-discharge check-ins have a two-fold advantage:

• They help catch complications early and mitigate growing issues, thus keeping patients out of the hospital.
• Reducing hospital readmissions has positive financial outcomes for healthcare organizations.

Design

Workflow configuration and monitoring for Admin
Multiple, pre-configured, automatic workflows, designed to cater to numerous healthcare use cases, that enroll all patients and keep them engaged in their health.