Care management workers at Inspira used to spend hours each weekday compiling a list of recently discharged patients for transitional care management outreaches. Implementing HealtheCare℠ automated 78 percent of the manual list creation.
Before January 2017, Inspira Health Network employees spent dozens of hours each week combing through records to identify patients who would benefit from additional services. After implementing HealtheCare℠, Cerner’s community care management solution, Inspira saved its workforce dozens of hours weekly.
Each weekday, care management workers would scour health information exchanges (HIE) and the electronic health record (EHR) to compile a list of recently discharged patients for nurses to perform transitional care management (TCM) outreaches. After switching to HealtheCare, the solution automatically compiled those lists. By implementing the solution, 78 percent of the manual list creation work across all primary care practices became automated.
“Now we can get started when the clock strikes 8 a.m. We don’t have to wait for that list any longer. The list is there, ready to go, and the nurses can hit the ground running,” said April Venable, director of population health, Inspira Health Network. “It saved my staff 50 hours a week.”
The readmission rate fell for patients who received transitions of care services from nurse care managers post-discharge. Using a government estimate of $11,200 average cost per readmission (according to the “Healthcare Cost and Utilization Project,”) Inspira leaders estimate they avoided $1.3 million annually in cost from reduced readmissions. (Data based off 2016 Medicare patients, then extrapolated across the primary care population who received TCM services.)
While Inspira realized impact within only a few months after implementation, leaders expect to broaden their reach in the future. The company plans to add algorithms within HealtheCare to touch more patients in the community. Automation freed up the capacity to accomplish this.
“I think we’ll continually identify new populations we want to work with. We started with some of the basics, and already have four or five new algorithms in the works,” said Venable. “We’re going to offer our service to local employers. We are looking to partner with community practices that are not employed by Inspira but are part of our shared savings program.”