Smartphone-enabled transitional care

As Rehabilitation Physicians, we  build strength and resilience in populations to reduce the risk for readmissions after discharge from a hospital or skilled nursing facility.  We use smartphone-enabled telemedicine and remote patient monitoring technology to provide additional support in the home. As specialists in multi-condition rehabilitation, we go beyond medications to treat the underlying risk factors for a rehospitalization.

Aging patients who are hospitalized are often exposed to risk factors that can increase vulnerability to a rehospitalization. These risk factors include flare-ups of pre-existing chronic disease, immobility, poor nutrition, multiple medications, high stress environments and disrupted sleep. This vulnerability to poor health and to recurrent hospitalization is known as frailty. Frailty remains the #1 syndrome not routinely assessed after discharge from a hospital or skilled nursing facility. 

We've now changed that.

 Our telemedicine rehabilitation program assesses and treats frailty in the home. We improve the transition to home at no cost to the referring hospital or skilled nursing facility.