Centura Health fuels population health with mobile app and medical concierges

The Colorado network’s South Denver unit is giving patients an app for house calls and assigning care coordinators to help navigate the system. And it’s already seeing Triple Aim results. 
By Bill Siwicki
07:43 AM

Centura Health’s South Denver operating group has been experimenting with two population health programs: a house call app and so-called medical concierges.

The largest health system in Colorado and Western Kansas with more than $3 billion in revenue and 17 hospitals as well as hospice, home care and other facilities, Centura embarked on the initiatives as part of its strategic transition from fee-for-service to value-based care.

The mobile app, from a startup company and medical practice called DispatchHealth, is designed to better serve patients who require urgent care, while the medical concierges help joint replacement surgery patients and their providers better navigate the complex process of surgery and recovery.

Taken together, the app and concierge-like care coordinators also enable Centura to strive for the Triple Aim of better patient care that creates healthier populations and does so at a lower cost.

Dispatch app
Patients can download the DispatchHealth mobile app onto their phones and use the software to contact local hospital providers when they are experiencing medical situations where they are not entirely sure they need to go to an emergency room. The goal of using DispatchHealth and its app is to reduce emergency room visits and subsequent hospital readmissions.


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“The app allows patients to interact with DispatchHealth and get a caregiver out to their home or business who can help them with immediate acute care needs,” said Kristen Daley, group director of value-based programs for the South Denver operating group at Centura Health. “If it’s a situation DispatchHealth caregivers cannot handle, they can get an ambulance there quickly. Nine times out of 10 when calls go to EMS, they end up being services that could have been provided in the home by DispatchHealth.”

A DispatchHealth house call costs $195 (the self-pay price). DispatchHealth worked with all payers in Colorado to ensure these house calls would be covered by insurance.

Medical concierge
On the care coordination front, Centura Health’s South Denver operating group has started something of a medical concierge service for joint replacement surgery patients.

“They are called transition care coordinators; they follow a patient from the moment the decision is made to have joint replacement surgery, an elective population we deem high-risk,” Daley explained. “The care coordinator calls their patient to discuss what the patient’s customized care program should look like, a customized discharge plan. And the coordinator confers with the surgeon and the surgeon’s team to make sure the customized plan is appropriate.”

As part of creating the plan, the coordinator also interviews a patient’s family members in the home to help construct the optimal discharge plan. The coordinator also examines skilled nursing facilities and home health services.

“They are like a medical concierge who customizes care. They visit the patient on the floor after surgery to make sure nothing happened during surgery that would change the plan. They work with the multidisciplinary teams, the physical therapists, occupational therapists, care managers, social workers,” Daley added. “When the patient is discharged, the care coordinator follows the patient to the post-acute care provider. The care coordinator follows the patient, meets with them daily and works with the multidisciplinary team.” 

[Also: Population health's biggest challenges: data, structuring services, engaging patients and evolving mindsets]

Right now this concierge program, which also includes 7-day, 30-day, 60-day, 90-day and 120-day follow-up calls and a 24/7 medical hotline, is just for joint replacement patients, but Daley said Centura Health will be expanding the program to include the health system’s Medicare Shared Savings Population.

Hitting the target: Triple Aim
Centura is achieving all three points of the Triple Aim of better outcomes for individual patients, healthier patient populations, and lower costs, Daley said.  

“We are making sure the discharge plan is appropriate and making sure the care they receive throughout the whole process is appropriate and timely. In the past, for example, we have had patients staying in skilled nursing facilities for a longer length of stay than is necessary,” Daley explained. “So now we feel transitioning patients to another care setting that is the right, safe place for them is better and at a lower cost.”

And the DispatchHealth app and 24/7 hotline are lowering emergency department visits and subsequently readmissions to hospitals, she added.

Patient satisfaction is higher, too, because of the app and the personal customer care coordinators.

“This program gives patients that personal touch and someone checking in on them, a security blanket they are really happy with,” Daley said.

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com


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