CipherHealth
OutreachPost-Discharge Follow-Up

Ensure follow-up happens after every discharge.

Automate post-discharge follow-up workflows that surface risks early, route issues instantly, and reduce avoidable readmissions — without adding staffing burden.

Recovery outcomes health systems see

41%

fewer 30-day readmissions (Intermountain)

$15M

savings (Intermountain)

36%

pediatric readmissions reduction (Seattle Children's)

Readmissions

−30% avoidable

Reached

98% in <24h

Nurse Worklist
Live
High-priority escalation
MR

Michael R.

High risk

Unit 4 West · CHF follow-up

  • Meds

    Adherent

  • Incision

    Swollen

  • Pain

    8/10

Today’s check-ins

  • ST

    Sarah T.

    Day 2 · knee

    On target
  • JK

    James K.

    Day 2 · CABG

    Watch
  • MP

    Marcus P.

    Day 28 · TCM

    Billed
Capabilities

Comprehensive follow-up that catches issues before they escalate

Automated Check-Ins

Reach every discharged patient with timely voice or text check-ins — no manual dialing, no missed follow-ups.

Escalation Workflows

Flag concerning responses instantly and route them to the right care team member for rapid intervention.

Condition-Specific Scripts

Tailor questions by diagnosis, procedure, or care pathway so follow-up conversations are clinically relevant.

Multilingual Support

Conduct follow-up in 30+ languages so language barriers never prevent patients from reporting concerns.

EHR Integration

Pull discharge data from Epic, Cerner, and other EHRs automatically — no duplicate entry, no delays.

Outcome Analytics

Track readmission rates, response rates, and escalation trends with real-time dashboards and exportable reports.

Structured post-discharge follow-up supports: readmission prevention, TCM completion, recovery confidence, clinician escalation accuracy.

Reliable execution

Check on Every Patient After Discharge

Automated outreach contacts patients within hours of leaving the hospital. Structured questions surface pain issues, medication confusion, and warning signs — so your team can act before a return visit.

See how it works
Post-discharge follow-up dashboard on a laptop showing incoming patient responses
Proven intelligence

Route Urgent Issues to the Right Team — Fast

When a patient reports a concerning symptom or missed medication, the system generates an alert and routes it to the appropriate clinician. No issues fall through the cracks.

Learn about escalation workflows
Nurse reviewing a patient alert card that has been escalated to her from an automated follow-up
Precision engagement

Bridge the Gap Between Hospital and Home

Extend the care experience beyond the hospital walls. Multi-touchpoint outreach over days and weeks keeps patients engaged, reinforces discharge instructions, and builds lasting trust.

Explore care continuity

30-day follow-up arc

  1. Hour 0

    Discharged

    Feed triggers from Epic / Cerner

  2. Hour 2–24

    First check-in

    SMS or voice in the patient's language

  3. Days 2–14

    Recovery tracking

    Signals escalate to the nurse worklist

  4. Day 30

    Recovery confirmed

    Patient reported stable, care loop closed

Reliable execution

Move Patients From Automation to a Live Voice

When a patient indicates they need help during an automated call, live transfer connects them instantly. No callbacks, no voicemail — just a seamless handoff to the right person with full context.

See how it works
Call center nurse on a headset with a live transfer status card floating beside her showing an active connected call
Preventing patient readmissions is what's important to us, and we had just under $15M in savings with doing these post-discharge follow-up calls. It results in greater patient satisfaction, lower readmission rates, and a significant financial impact in our healthcare organization.
BB
Ben Becker, DNP, RN, NEA-BC
Director, Enterprise Care Management, Intermountain Healthcare
Intermountain Healthcare
41%Fewer 30-day readmissions
Get started

See Post-Discharge Follow-Up in action.

Schedule a personalized demo and discover how automated follow-up helps health systems reduce readmissions, improve outcomes, and elevate the patient experience.