Leveling Up on Post-Acute Care Collaboration with Network Insights

Wednesday, April 19 at 10:00 AM - 11:00 AM CT
South Building, Level 4 | S403
Today, 1 in 4 patients are sent back to the hospital within 30 days of a SNF admission and 40% do not successfully transition from SNF to home or the community. Key drivers of readmissions include limited access to data, poor coordination during transitions of care, and ineffective collaboration between cross-continuum stakeholders. Ultimately, this leads to wasted resources, unnecessary costs, and subpar patient outcomes. In this presentation, health system leaders describe effective strategies for addressing readmissions by focusing on technology-enabled post-acute care management. Their results highlight the importance of sharing data across the network, as well as the value of real-time clinical data and machine learning to support transitions of care and drive deeper collaboration with their post-acute partners.

Learning Objectives

  • Break down data silos impacting transitions of care between acute and post-acute settings.
  • Identify ways to leverage real-time insights and machine learning to improve patient monitoring during a care episode.
  • Define how to effectively monitor post-acute network performance and create new levels of collaboration through transparency.
Chief Quality Officer and Chief Clinical Transformation Officer, CIO/CTO/CTIO/Senior IT, Population Health Management Professional


Danielle Salazar
Assistant Director, Post-Acute Network
RWJBarnabas Health
Nikki Starrett, MS
Sr. Director, Solution Design