Readmissions Reduction

Readmissions Analytics leverages a set of powerful predictive algorithms from Intermountain Healthcare to identify upon admission, patients with conditions that put them at risk for readmission.

CareCentra takes a comprehensive approach to reducing readmission rates by working with patients from the time they are admitted to the hospital through their discharge and return home. Our Readmissions Analytics uses highly effective predictive algorithms from Intermountain Healthcare to help providers identify and stratify patients at highest risk for readmission.


Intermountain’s Clinical Risk Algorithms Prevent Hospital Readmissions

  • We’ve incorporated proprietary predictive algorithms and clinical risk models from Intermountain Healthcare to help providers and care coordinators determine those patients at risk of readmission.
  • Developed at the Heart Institute at Intermountain Medical Center and in use at Intermountain Healthcare for all patients regardless of diagnosis, their Readmission Risk Score (RARS) comprises is a package of three risk assessment algorithms that can help physicians identify and stratify their patient population by (a) overall health risk (30 day/1 year); (b) 30-day readmission risk for Heart Failure (HF) and (c) 30-day readmission risk for Acute myocardial infarction (AMI).
  • RARS uses results from a simple blood test, the complete blood count (CBC) and basic metabolic panel (BMP), making it relatively easy and inexpensive to obtain and implement in any clinical setting.

Readmission Risk Score Highlights

  • RARS allows physicians to identify and stratify clinical risk in real-time, patients “at risk” of HF and AMI and those “at risk” of re-hospitalization, avoiding unplanned admissions, reducing emergency department congestion, and reducing in-patient costs. The Readmission Risk Score:
  • Identifies patients likely to readmit.
  • Provides a readmission risk score for each patient at admission.
  • Updates a patient’s readmission prediction throughout their stay from triage to discharge.
  • Provides reporting and analytics that track and measure readmissions, and identify key improvement drivers

Patient Activation Essential to Improved Outcomes

  • Sitting atop CareCentra’s Intelligent Health Platform, Readmissions Analytics leverages the platform’s powerful segmentation and behavioral modification tools to identify those individuals most in need, and those most likely to benefit from preventive care.
  • The results can be used to develop intervention strategies that focus resources that ensure these patients get the appropriate amount of care and post discharge treatment.
  • The solution measures the impact of post-discharge interventions in a continuous feedback loop to monitor and track progress and early deterioration.

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