Nexus Health Resources, a leader in transitional care software and services, announced today that Greystone Health Network has chosen the company’s flagship software product NexusConnexions to power its transitional care program in its 36 skilled nursing locations.
In response to the healthcare progression from fee-for-service to value based care, Greystone Health Network initiated a transitional care program with dedicated Transitional Care Coordinators (TCC). The TCCs are responsible for working with patients and family members from admission to the skilled nursing facility through discharge to home to ensure continuity of care and reintegration into their community.
“The NexusConnexions software allows us to streamline our post-discharge follow up calls and activities,” said Greystone Health CEO Connie Bessler. “The automation and scripting in the software system allows us to standardize our approach across our diverse geography and because we’re capturing all activities, we can report those outcomes to our ACO and health system partners.”
NexusConnexions allows skilled nursing providers to easily interact with patients after discharge, easing their reintegration into community and reducing the risk of hospital readmission.
“Skilled nursing providers are facing unprecedented market pressures,” said Nexus Health Resources CEO Dr. Virginia Feldman. “ACOs and health systems are narrowing their post-acute networks while asking providers to shorten length of stay, decrease total medical spend and also mitigate unnecessary hospital readmissions. We built NexusConnexions in response to this market need and to assist high quality providers, like Greystone, in answering the challenge of high quality patient care at a lower cost.”
In streamlining transitional care activities, NexusConnexions uses patient risk stratification, demographics and diagnosis to assemble specific call schedules, agendas and scripts that enable care coordinators to deliver a standardized, yet custom patient experience.
“The ability to electronically manage post discharge calls and follow-up activities has been a key to our transitional care program,” said Gregg Clavijo-Hopper, VP of Business Development for Greystone Health. “Since we are capturing all our activities electronically we have the ability through NexusConnexions to report outcomes and interventions which has been warmly received by our referral partner ACOs and health systems.”