Reduce Hospital Readmissions and Improve Patient Outcomes using AWS

Reduced hospital readmissions are critical for an effective functioning healthcare system. This becomes increasingly important given the way the current COVID 19 pandemic is testing the limits of the healthcare systems across the globe. In this article, we will look at how AWS Healthcare partner solutions help with achieving that objective. We will use the conclusions and recommendations made by the comparative study, Successful hospital readmissions reduction initiatives – Top five strategies to consider implementing today as a basis to address this issue.

1. Home Visits
2. Education
3. Discharge Planning
4. Collaboration
5. Telephone Follow Up

The study suggests that voice/phone conversations are key when engaging patients. AWS offers robust tools to create and support voice communication system to help with that. For each of the strategy listed above, a common trigger that can be used are HL7 (Health Level 7) messages. HL7 messages are used by virtually every healthcare organization. The Electronic Medical Record Systems are already generating specified messages required. Only an additional end point needs to specified to provide an automatic trigger

Amazon Connect is an omnichannel cloud contact center that makes it easy for organizations to deliver superior customer service. In fact, it is the same technology that powers Amazon’s customer support and enables millions of customer conversations daily. Using Amazon Connect, you can set up easy call flows such as Press 1 if you’d like to set up a call with your physician which then routes the patient to physician’s office for scheduling. You can enable multilanguage and natural human language support to help a diverse set of audience. You can also automate outgoing calls using an API or Command Line Interface (CLI).

Architecture and Set-Up
There are many options to set up HL7 messages to trigger calls in AWS. The most common one is to use the Apache Camel utility to serve as an HL7 listener and put and object into AWS S3. Determine an appropriate HL7 trigger message to start the workload. For the discharge planning call flow for example, healthcare organizations may already have an existing discharge chart and discharge messages that can be copied to the Camel Listener. We’ll now walk through the set up for each of the enlisted strategies above.

Home Visits
They are probably the most effective way to prevent hospital readmissions. We need to determine if a patient or the point-of-contact desires a visit, and, if so, to schedule the visit. A call flow is created in Amazon Connect with the customer (patient’s) input being the entry point. The patient is called and queried whether a home visit is desired. If the response is yes, the contact is connected to the call queue where an appointment can be set up.

Education
Post hospitalization care and wellness education needs to be internalized by the patient and caregiver to be effective. It is extremely import to ensure

1. Patient understands the instructions before leaving the hospital and
2. Follow up after discharge to verify that instruction has been retained and is being followed

Call flow can include questions such as

• Do you understand how to take care of yourself after the recent hospital stay?
• Do you have any questions about the problems you are experiencing?
• Do you have any problem performing the exercises that were prescribe when you were discharged?

If the answer to any of these is negative, the patient is routed to a nurse for consultation and reinforcement of what was explained.

Discharge Planning
It is crucial to complete all essential steps before discharging patients. Failure to do so increases the chances of readmission. A call flow can be designed such that verification of all critical steps for the discharge process can be done. If possible, patient (or the caregiver) should be contacted on their cell phone. However, if the patient doesn’t have a cell phone, hospital’s care facility’s room may be substituted. Call flow can include questions such as

• Do you have medication prescriptions?
• Do you have your discharge instructions?
• Do you have any questions about the instructions?
• Do you have transportation from the hospital?
• Do you know how to schedule follow up appointments?

If the answer to any of these is negative, the patient can be routed to the discharging nurse for consultation.

Collaboration
Similar to the above listed methods, a call flow can be created to ask questions such as

• Have you scheduled follow up appointments?
• Did you miss any follow up appointments?
• Do you have transportation for the appointments or need help with that?

Proper care after discharge is important to reduce the chances of readmission. This call flow can help the hospitals verify that.

Telephone Follow Up
With Amazon Connect, Telephone follow ups become easy to schedule and implement. System can call the patient, ask whether they are well, and determine if they need medical assistance.

Security & Privacy
We’ve seen how AWS services can help smoothen the post hospital care and reduce the readmission rates significantly. However, it’s important to ensure data privacy and security in the process. Let’s look at how AWS can help with both.

Security
There are several healthcare solutions in the AWS Marketplace that offers a set of robust tools to help you establish secure call flows. You can integrate AWS Identity & Access Management (IAM), AWS Security Token Service (STS), AWS CloudTrail and AWS IoT Device Management for the following purposes

• IAM to maintain sanctity of access and user control
• STS to provide security credentials to third party admins and providers
• CloudTrail to log your API calls
• IoT Device Management to securely onboard, organize, monitor, and remotely manage devices?
• You can learn more about AWS Security here

Privacy
As a customer, you maintain the complete ownership of your data and select which AWS service can process, store, and host content. AWS doesn’t access or use customers’ content for any purpose without their consent. You can review AWS policies here.

As you’ve seen above, AWS can be your trusted partner and implement a robust post discharge system that makes sure your patients receive excellent support to help them recover and reduce their chances of readmission. We at Teqfocus help organizations scale up and transform using AWS. Our team of consultants and domain experts can work with you to implement these systems and support them. Let’s talk if you’d like to know how.