Company
Mount Sinai Health System
Company Size
Large-size
Commure Products Used
About the Company
The Mount Sinai Health System is the largest hospital network in New York City. It was formed in September 2013 by merging the operations of Continuum Health Partners and the Mount Sinai Medical Center.
Situation
Improving Orthopedic Care with Patient Education and Clinical Care Coordination
Mount Sinai Hospital (MSH) participates in the mandatory CMS bundle for comprehensive joint replacement (CJR) – an efficient care process for patients initiating from hospitalization throughout recovery that encourages hospitals, physicians, and post-acute care providers to work together to improve the quality and coordination of care. MSH’s bundled payment strategy focuses on the development and implementation of a standardized care based model built around evidence-based best practices to achieve the Quadruple Aim.
- Hip and knee replacements are the most common inpatient surgeries for Medicare beneficiaries and can require an extensive recovery and rehabilitation period.
- A single musculoskeletal readmission costs $17,500 on average – the sixth most expensive principal diagnosis category for average cost of 30-day all-cause readmissions.
- Consistent and timely communication, including evidence-based patient education, is essential for ensuring good health comes.
Action
A comprehensive digital navigation program to guide patients and their caregivers through pre-surgical preparation and recovery.
To support this strategy, MSH launched a comprehensive digital navigation program, in partnership with Commure Engage, to guide joint replacement patients and their caregivers through pre-surgical preparation and recovery. The program included three therapeutic modules, including that providers could prescribe via the EHR.
Within the custom Digital Navigation Program modules, evidence-based messages were programmed to automatically send at specific times and included medication reminders, exercise instructions, and suggestions for how to prepare for optimal recovery post-procedure.
The messages specifically targeted key objectives:
- Automating patient education and support during all stages of care
- Engaging even non-digital native populations (ages 65+)
- Improving quality of care and significantly reduce LoS and readmissions
Result
Improved outcomes for patients enrolled along care pathways.
Given the success of this program, next steps include scaling the program across the health system and adding Spanish-language support. Similar programs are being implemented for other surgical and disease use cases.
1.5 day reduction in Length of Stay (2.81 days vs. 4.31 days)
34.5% reduction in 30-day readmission rates (1.9% vs. 2.9%)
20% more patients discharged directly to home (87.8% vs. 65.3%)
14.6% higher ambulation rate on day of surgery (47.9% vs. 33.3%)
Commure Engage provides healthcare organizations with a powerful platform to coordinate clinical care pathways using automation and AI to create efficiencies for patients and care teams.
Active, engage, and monitor patients with easy scheduling, dynamic nudges, educational content, patient reported outcomes, real-time messaging, and more.
Original published study: Rogers J, Fasihuddin F, Black M, Kann R, Mei S, McLaughlin J, Atreja A: Developing and Implementing a Digital Navigation Program to Improve Outcomes for Medicare Bundle Patients Undergoing Joint Replacement Surgery, iproc 2019;5(1):e15197.
