Phytel Transition™

Empowering Patients to Improve Outcomes

When patients are discharged from the hospital or emergency room, they need to understand their post-discharge instructions and the importance of complying with care directives so they can recover quickly and avoid costly readmissions or emergency room visits.

However, identifying risks and addressing patient and family caregiver knowledge gaps can be expensive and time-consuming – unless you have the right tools.

The Phytel Transition™ toolkit empowers patients and improves outcomes by:

• Providing a comprehensive discharge and ER outreach program including 100% patient follow-up to enhance compliance and patient satisfaction
• Facilitating delivery of services to support recovery within the critical first 24-72 hours after discharge
• Optimizing post-discharge call programming and minimizing avoidable readmissions

The Phytel Transition™ solution helps hospital care teams empower patients to take charge of their own care and improves patient satisfaction.

Post-Discharge Follow-up Survey

Gauge patient satisfaction, identify potential risks and monitor conditions.

• Patient communication, outreach tools and a patient satisfaction assessment
• Auto-generated contact inviting 100% of eligible patients to take a survey 24-72 hours after discharge
• Triage system immediately routes patients to nurse champions within the hospital

At Risk Protocol Engine

Ensure post-discharge attention for high-risk patients, such as those with congestive heart failure diagnoses.

• Clinical rule sets identify high-risk patients or patients who fit defined criteria
• System of alerts, notifications and reports help case managers manage high-risk patients
• Automated communications every day request information about pain levels and manage vital communication issues

Care Management Transitions and Work List

Generate proactive patient communications and care teams alerts.

• Escalation alert to care coordinators enables rapid response to critical issues
• Repository of medical history from primary care physician supplements hospital coding and data
• Notification to care managers and primary care physicians when patients within their panels are discharged

Better Patient Experience

• Improves patient satisfaction by delivering support
• Increases access to vital information
• Reduces complaints with proactive communication

Reduced Costs

• Reduces readmissions by ensuring compliance
• Decreases care expenses by supporting recovery in a less acute environment
• Increases hospital capacity by preventing unnecessary readmissions

Better Quality Care

• Improves clinical outcomes with proactive support
• Decreases adverse events by identifying risks
• Improves patient safety with post-discharge guidance