Joining the Dots With AI-Supported Care Coordination
The Ask
Patients were slipping through the cracks between appointments, referrals, and follow-ups. Coordinated reminders kept the next step from being forgotten.
- With no reliable thread connecting appointments, referrals, and follow-ups, patients dropped out of their own care plans without anyone noticing until it was late.
- For conditions that need continuity, those gaps translated directly into worse outcomes and repeated work.
- Care coordination clinic [NDA]
- Outpatient healthcare
- GCC
- Care coordination
- Care coordination clinic [NDA]
- Outpatient healthcare
- GCC
- Care coordination
Background
Care did not always end where the visit did, and the space in between was where patients got lost. Referrals were forgotten, follow-ups were missed, and the next step in a patient's journey too often depended on them remembering it themselves.
Challenges
Approach
Results
Fewer patients slipped through the cracks, follow-through on referrals improved, and care felt like a connected journey rather than a series of disconnected visits. The clinic spent less time recovering lost patients and more time treating them.
- Outcome Fewer patients slipped through the cracks, follow-through on referrals improved, and care felt like a connected journey rather than a series of disconnected visits. The clinic spent less time recovering lost patients and more time treating them.
Patients lost between referrals and follow-ups?
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