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Readmission Risk Agent

Quality & SafetyQuality Outcomes

Scores 30-day readmission risk at discharge and triggers care management and follow-up protocols.

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Process steps
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Integrations
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Data inputs

Many preventable 30-day readmissions stem from missed follow-up, medication confusion, and unaddressed social risk that are not acted on at discharge

Risk scores arrive too late or without clear next steps for care managers

High-risk patients leave without scheduled appointments or home support

The Readmission Risk Agent scores risk at discharge and automatically triggers care management and follow-up protocols matched to patient need

At discharge planning and final disposition, the agent computes 30-day readmission risk from clinical, utilization, medication, and social features; assigns protocol pathways; and launches follow-up scheduling, pharmacy reconciliation support, and care management outreach with tracked completion.

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Score 30-Day Readmission Risk at Discharge

  • Combine diagnoses, prior utilization, length of stay, vitals trends, and polypharmacy signals
  • Incorporate SDOH, payer, and post-acute disposition factors
  • Generate an interpretable risk score with top contributing drivers
Outcome: Each discharging patient has a transparent 30-day risk score and driver list.
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Select Care Management and Follow-Up Protocols

  • Map risk tiers and conditions to protocol bundles such as HF, COPD, or general high risk
  • Determine required follow-up windows, telemonitoring, and pharmacy touchpoints
  • Identify barriers such as no PCP, transportation, or language needs
Outcome: Patients are matched to the right post-discharge protocol intensity.
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Trigger Scheduling, Outreach, and Handoffs

  • Create follow-up appointment requests and care manager tasks before discharge when possible
  • Alert outpatient clinics, home health, and pharmacy teams of high-risk discharges
  • Deliver patient-friendly discharge checklists and medication teach-back prompts
Outcome: Follow-up and care management actions start without manual handoff gaps.
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Monitor Protocol Completion and Readmission Outcomes

  • Track completed follow-ups, outreach attempts, and medication reconciliation within target windows
  • Flag patients who miss first follow-up for rapid re-engagement
  • Report 30-day outcomes and protocol effectiveness by service line
Outcome: Readmission prevention workflows close the loop from risk score to measured outcome.
EHR discharge workflows
Care management platforms
Ambulatory scheduling
Pharmacy systems
Post-acute and home health partners