Care Continuity's ED-Post Discharge Patient Navigation program is a data-driven patient navigation service designed to reduce patient outmigration and grow profitable service lines. 

Care Continuity leverages a purpose-built software that utilizes AI and machine learning to analyze dozens of data points and social determinants of care that make it possible to prioritize patients for outreach based on their need, and to maximize the downstream effectiveness of a patient navigation program. In addition, the software is supported by a team of trained concierges that do the navigating on your behalf, allowing your team to continue working at the top of their license.

With the ED Post-Discharge solution, Care Continuity drive 12 - 15% service line growth while reducing unnecessary ED returns by an average of 33%. 

Care Continuity's team of specially-trained patient navigators are dedicated to providing the best experience for every patient, leading to increased patient satisfaction and loyalty.

Founded in 2014, Care Continuity provides expert patient navigation solutions that are designed to bridge gaps in healthcare, providing seamless transitions between care settings, reducing network leakage, and promoting optimal health outcomes and patient satisfaction. Through a combination of advanced software, AI and a dedicated team of care concierges, we help guide patients through their care journey while maintaining the integrity of the health system network. This translates to greater patient satisfaction, better health outcomes, and increased margins for our clients.

Health Systems/ACOs/DSRIPs/CINs

• Reducing patient leakage through SmartMatch decision support and real-time analytics

• Standardizing and streamlining the referral management process across the organization

• Driving operational efficiencies and allowing referral teams to scale more efficiently

PCPs/FQHCs/Dental Practices

• Matching patients with most appropriate providers using SmartMatch decision support

• Closing the feedback loop with specialists and reducing phone calls and faxes

• Increasing patients LTV to ensure they are not lost to competitors after referrals are sent

Specialty Care Organizations

• Increasing referral volume and capturing more revenue using CRM and marketing tools

• Improving customer service with referring providers through automated status reports

• Managing referral network and gaining insight into referral patterns using analytics

ReferralMD delivers proven referral management, patient access and e-consult solutions that help hospitals, health systems, networks, and payers streamline the referral process, decrease patient leakage and improve communication between providers and patients. The enterprise platform matches patients with the most appropriate providers and closes the feedback loop between providers and patients. The solution’s powerful workflow and clinical decision support tools help healthcare providers increase revenue, drive operational efficiencies and improve customer service. To learn more about ReferralMD, please visit www.getreferralmd.com.

Leading EHR functionality takes a very basic approach to patient navigation. When utilized, the EHR prioritization queue is binary, labeling every patient as urgent or non-urgent. Instead, Care Continuity not only expands the total number of evaluated data points needed to properly prioritize a patient, but Care Continuity also expands the priority listing to 10 levels, allowing for a more nuanced and tailored navigational experience. 

In addition, the EHR functionality requires the health system to staff a team of navigators. Unfortunately, this largely non-clinical function is staffed by clinical staff, severely hampering their ability to work at the top of their license. 

Care Continuity pairs their purpose-built software with a team of trained, non-clinical concierges who are experts in patient experience and proper navigation.

With more than a decade of experience working with the nation's leading health systems, Care Continuity has had the honor of navigating millions of patients through the healthcare continuum. 

Leveraging purpose-built software with proprietary algorithms designed to efficiently navigation patients, Care Continuity can provide a customizable, high-ROI solution for health systems of any size.

• Online Scheduling – new patients can book appointments from your website without setting up an EHR patient portal account
• Referral Management – website portal for receiving referrals, customized workflow, automated alerts when referrals need attention
• Patient Communications – automated text/email messages sent to patients triggered at specific steps in the consult or referral journey
• Provider Communications – automated consult and referral status updates sent to sending providers to close the loop between PCPs and specialists
• Fax Management – manage all inbound faxes and push faxed referrals into the referral workflow, ability to split faxes into multiple documents
• Marketing CRM – physician liaisons can document outreach and compare outreach activity with referral volume from their partners
• Market Research – over 7 million providers pre-loaded which allows you to identify new potential referral partners in your target markets
• Referral Analytics – comprehensive suite of analytics to report on all your referral metrics (trends, volume, leakage, service levels, outreach, etc.)

Differentiator 1: All-In-One Platform

• Some vendors offer patient access, referral management, e-consults or CRMs. Our cloud-based platform offers them all plus the following features.
• Real-time analytics across the platform
• Automated workflow and decision support tools
• Automated feedback loop with referring providers
• Automated patient communications via text or email
• Integrated fax management system (port over existing fax numbers)
• Integrated Customer/Partner Relationship Management (CRM/PRM)
• Marketing research tools based on a directory of over 7 million providers

Differentiator 2: Rapid Integration Capabilities

• Our integration engine allows our Integrations Team to quickly deploy system interfaces using APIs, FHIR, HL7, Direct, etc. which is important when implementing the platform for health systems, ACOs and CINs with many EHRs, data warehouses and other third-party systems across their networks.  
• In addition, we comply with the third-party system’s specifications rather than asking the vendor to follow our requirements which streamlines the integration process and reduces cost for the client. 

Differentiator 3: All Healthcare Referrals Supported

• The system is highly configurable and can support all healthcare referral types such as medical, specialty care, therapy, imaging, dental, behavioral health, hospice, home care, etc.  
• The customization in the system allows clients to define their own workflows, referral forms, patient communication templates, and other settings that can be standardized across the organization.