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Machine Learning, Care Transitions, and Clinical Pathways Reduce CHF Readmissions by 46%

Partnership of clinical excellence and artificial intelligence achieve milestone in proactive care

Health Resource Solutions (HRS Home Health) announces the company achieved another milestone in their progressive approach to improve care for chronically ill patients. Over the last two quarters, (Q4 2017 and Q1 2018), HRS attained a 46% reduction in the readmission rate of their Congestive Heart Failure patient population. This achievement stems from the marriage of a dynamic patient management solution driving care transitions and the clinical pathway protocols at HRS Home Health.

The CHF patient population, notably one of the most highly readmitted diagnostic groups nationwide, has been engaged in this approach during the last six months. The CHF program utilizes the dynamic patient management system, provided by Wanda, Inc., which is embedded with machine learning to power the clinical decision process. Wanda continuously evaluates subtle changes in a patient’s clinical, social, and behavioral health determinants to warn when an adverse event is likely to transpire – seven days in advance of the occurrence. Prior to engaging this methodology, this group of patients had a 34% 30-day readmission rate making them among the highest readmission rate groups for HRS. By integrating this technology with services and care pathways, HRS reduced the 30 day readmission rate to 18.6%

“HRS is excited to drive value and make a measurably positive impact on the lives of our CHF population. With Wanda, our clinicians are able to make more informed and timely decisions, which help us avoid unnecessary adverse events for our patients,” said Glenn Steigbigel, CEO of HRS. “As providers, we are imbuing clinical processes with modern technology, which empowers our clinical teams with real-time actionable information to improve patient care. This approach benefits patients by providing them with the support they need while simultaneously reducing the total cost of care.”

As high-risk CHF patients are identified, Wanda facilitates real-time case management. This is accomplished by empowering clinicians with virtual intervention features to proactively engage them in care plan adherence and prevent avoidable adverse events.

“The incredible results that HRS is achieving are fantastic and we look forward to continuing our partnership to improve care,” said Foad Dabiri, CEO Wanda, Inc. “Proactive, real-time data science is how healthcare will achieve the levels of care and compliance needed to meet today’s expectations.”

Read more about our remote patient monitoring program here.


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