MDnetSolutions Care Transition System | Page 3

4) Each phone survey is built using branch logic – in other words, CTS knows what questions to ask based on responses to previous questions. The system can drill down where necessary or skip questions that aren’ t relevant.
5) The survey responses are immediately recorded in a secure database stored in the cloud. Patients whose responses indicate they need additional support are flagged.
6) Members of the care team who are responsible for reviewing the survey data simply log into our web-based dashboard, to quickly see how many patients answered a survey on any given day and how many have been flagged as needing a follow-up call from a clinician.
7) Care team members can add comments and create clinical documentation of follow-up care within the platform and share progress notes with referring providers.
Because patients get to choose what time to receive their call, they are more likely to respond. On average, our response rate is 86 percent.
Providers benefit from a streamlined workflow, as well as the ability to capture data on all patients while knowing at a glance which of them need prompt intervention.
Meticulous Survey Design
CTS offers IVR surveys in six specialty areas:
• Asthma
• Congestive heart failure
• Chronic obstructive pulmonary disease( COPD)
• Post-op general surgery
• Post-op joint replacement
• Diabetes
Each of the surveys are peer-reviewed by specialists in their field to ensure we’ re asking patients the right questions and providing appropriate response choices. The survey content is also weighed against the latest evidence-based research in that particular area of medicine.
Following approval by clinical experts, our team converts the language to a 6 th-grade reading level and develops algorithms for each of the 15 surveys conducted during the 30-day time period. These unique algorithms stratify patients into high, moderate or low-risk categories based on their responses during the phone calls.
To illustrate how a patient with asthma would interact with a disease-specific survey, he or she may be asked the following questions throughout the month:
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