Coronary artery bypass graft (CABG) surgery is the second most common cardiac surgical procedure performed in the United States. Unfortunately, this surgery is associated with a high number of unplanned hospital readmissions. According to the Healthcare Cost and Utilization Project, the average readmission rate after CABG surgery is 15.1% and, they note, some hospitals may have significantly higher unplanned readmission rates. In fact, a study conducted by The Society of Thoracic Surgeons found unplanned readmission rates following CABG as high as 23%. These unplanned readmissions represent significant expense for the public and great risk to the patient. Readmissions such as these should be curtailed and can be with improved patient communication and education at discharge and during follow-up care.
In 2019, the Centers for Medicare and Medicaid Services (CMS) added CABG to the six condition/procedure-specific 30-day risk-standardized unplanned readmission measures they track as a component of The Hospital Readmissions Reduction Program (HRRP). This program supports a national goal for the improvement of healthcare for Americans by linking payment for services to the quality of hospital care, of which unplanned readmissions are a key unit of measure. As a Medicare value-based purchasing program, CMS can reduce payments to hospitals with excess readmissions.
Crucial to reducing these costs and risk of patient morbidity and mortality is the development and implementation of appropriate multifaceted interventions that improve patient outcomes upon hospital discharge. Achieving the highest level of physical health and quality of life for patients following CABG is often made more challenging by common comorbidities associated with ischemic heart disease. After the patient is discharged, any number of conditions may arise that can cause a decline in postoperative health requiring readmission and placing the patient at higher risk for morbidity or mortality. How, then, can hospitals better assess high risk patients and engage CABG patients in their recovery post-discharge?
Hospitals must carefully implement a potentially complex discharge transition to reduce the risk of unplanned readmission following CABG Surgery. Discharge procedures may vary depending on specific patient needs and whether the patient is being discharged home or to a care facility. Regardless of where the patient receives the next level of care upon discharge ─ a rehabilitation (rehab) center, skilled nursing facility (SNF), assisted living community or home ─ the way this transition is planned and handled can dramatically influence the patient’s recovery success.
Continuity of care is the foundation of patient health and satisfaction during transitions from one care provider to another. The most effective means of ensuring continuity of care is patient-centered communication among all stakeholders. Yet, a study conducted by the University of California, San Francisco and published in The Journal of the American Medical Association (JAMA), found more than 25% of hospital readmissions could be avoided with better communication among healthcare teams and between providers and patients.
According to a study published in the July 2019 issue of The American Journal of Cardiology, CABG Surgery readmission costs an average of $13,392 per patient, accounting for an estimated annual cost of over $250 million. A study conducted by the Pennsylvania Health Care Cost Containment Council found that as many as 35% of CABG Surgery patients were readmitted to a different hospital from the one where they received their surgery, which exemplifies care management communication failure. These rates of readmission are increasingly scrutinized and reported. This performance data will, undoubtedly, continue impacting reimbursement rates.
Ideally, care transition plans identify potential complications and comorbidities specific to the diagnosis being treated. This is especially true for surgeries and other procedures that are shown to involve greater risk factors for readmission due to post-op complications such as CABG.
Because patients who undergo CABG Surgery are known to be at increased risk for complications and readmission, a chatbot designed specifically for post-CABG patients is far more effective at reducing those risks. A chatbot that knows when to prompt the recovering CABG patient and what data to solicit creates proactive dialogue between the healthcare organization, primary care physician, the patient, and the patient’s care team. This dialogue facilitates the monitoring of the recovery progress specific to those concerns most common in post-CABG patients.
A chatbot is a computer program that utilizes artificial intelligence (AI) designed specifically to enable dialogue with people via automated, scripted text messages, as well as live-agent text messaging. Businesses use chatbots to attract, keep and satisfy customers. A chatbot is like a virtual assistant. By maintaining a conversation providing information and solutions, a chatbot can save time and ease communication. For instance, chatbots can book appointments, provide service information and even coordinate services. The underlying benefit to any chatbot is the facilitation of communication.
In a healthcare setting, chatbots are used to combat communication gaps and ensure proactive communication between patients and their care provider. Innovative technologies and personalized programs are being increasingly implemented with promising results. These innovations provide improved patient engagement, enhanced patient experience, increased data interoperability, patient health information (PHI) security, and improved patient outcomes.
Ranging from patient reminders to the identification of symptoms, medication management and chronic condition monitoring while protecting sensitive PHI, these new technologies are creating a digital ecosystem of ‘smart health.’ A key component of the digital ecosystem, automated chatbots powered by AI are enabling convenience-driven access to care and nurturing proactive two-way relationships between patient and care provider.
QliqSOFT, a leading developer of HIPAA-compliant, innovative healthcare communication technology solutions, has created ‘Quincy,’ a healthcare-specific chatbot that provides personalized and scalable communication that improves patient experience and patient outcomes.
As a conversational patient engagement platform that leverages AI technology, Quincy is dynamic, smart, flexible and scalable. Quincy is designed to implement easily by selecting from a pre-built library of healthcare-specific chatbots such as the CABG surgery chatbot, or healthcare providers can customize Quincy to suit their specific needs. Either way, the Quincy chatbot facilitates and promotes patient engagement.
Healthcare providers know that in order to prevent readmissions, post-CABG patients must be informed and empowered. The absence of very clear, concise and ongoing communication between the patient and care teams, sets the stage for potential readmission.
Rather than simply collecting generic patient assessment information, the Quincy CABG surgery chatbot is designed to collect care assessment data relative to the 10 most common causes of readmission after CABG, which provides opportunity for the care team to intervene early and proactively, thereby reducing the patient's risk of readmission. Additionally, the Quincy CABG chatbot provides a personalized patient experience through which self-care recommendations are shared, patient questions are answered, data transmitted via radio frequency (RF) from medical devices is received, and the patient remains connected to the care-team all while protecting PHI.
Often, patients interpret discharge as synonymous with completed treatment. This misinterpretation can lead to poor patient outcomes and costly readmissions. The Quincy post-CABG Surgery chatbot guides CABG patients through their recovery upon discharge to ensure instructions are followed and symptomatic changes are addressed. By proactively providing personalized, targeted education and care assessments specific to the most common causes of readmission following CABG, the Quincy post-CABG chatbot helps reduce readmissions and costly, avoidable complications.
According to a study published in The U.S. National Library of Medicine (NLM), more than 60% of CABG surgery readmissions are estimated to occur within 10 days of discharge. Given the high costs and the frequent readmission and morbidity associated with CABG, if hospitals are to curb CABG readmissions, these care facilities must implement multimodal and multifaceted intervention programs that break from traditional means and embrace new technologies enabling proactive patient engagement and improved patient outcomes.
Hospitals that demonstrate lower CABG readmission rates have a market advantage. Care-quality data published through initiatives such as HRRP influences healthcare consumer decisions when choosing healthcare providers. Those hospitals with lower readmission rates attract more opportunities to deliver care and experience fewer financial penalties from federal funding sources such as CMS. Ultimately, patient experience plays an increasingly influential role in driving healthcare consumerism. Hospitals that provide a satisfying patient experience through patient engagement become the providers of choice.
By embodying the role of a virtual assistant, the Quincy CABG chatbot is pivotal in bridging the gap between post-op CABG patients and their care teams. In her healthcare analysis entitled “2019 Global healthcare outlook ─ Shaping the future,” Dr. Stephanie Allen, Deloitte Global Public Health & Social Services sector leader wrote, “Digital innovation is supporting and augmenting workers and not replacing them. It is allowing highly trained resources to focus on more valuable, patient-facing activities.”
Clearly, digital innovations are improving healthcare delivery efficiency and accessibility. These technologies are yielding innovative models of patient-centered care and smart health approaches that are reducing costs while increasing access, affordability, and quality of healthcare. QliqSOFT is pleased to be a leading innovator providing solutions that improve the delivery of healthcare for all.
QLIQ HERE to learn how the Quincy CABG surgery chatbot can improve your patient outcomes.
A lifelong communicator, this Tennessee native got his start in broadcast news before branching out into public media, corporate, communications, digital advertising, and integrated marketing. Prior to joining QliqSOFT as the company's first marketing team member, Ben shared his talents with organizations that include the University of Alabama, iHeartMedia, and The Kroger Company.
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