Utilizing Transitional Care Management Protocols to Reduce 30-Day Readmissions

Florida-based Orlando Health Network (OHN), a leading Clinically Integrated Network (CIN) with over 300,000 patients and more than 5,500 physicians needed to reduce its readmission rate. The organization is the largest clinically integrated network in the broader Orlando market. This session will highlight how Orlando Health Network (OHN)—a leading clinically integrated network—deployed a comprehensive, data-driven transitional care management solution. The solution provides access to patient data that empowers care teams to automate workflows and personalize care. OHN also streamlined its value-based initiatives using actionable analytics and used a unified data platform to create a 360-degree view of patients to find gaps in care, build patient registries, identify coding opportunities, and track quality measures. The result? OHN care managers built personalized care plans, executed 11,500 care management protocols, reduced the 30-day readmission rate by 4.3%, and saved more than $4 million.