Readmission risk assessment

Abstract

Readmission risks of patients admitted to a healthcare facility are determined using a generic readmission risk algorithm. The readmission risk assessment of patients may be based on portions of a patient's profile and may be performed before, during, and after their index admission. Based on the readmission risk assessment of patients, those patients that are at a greater risk for readmission may be identified. A readmission prevention worklist may be provided that identifies those patients and facilitates managing the risk of readmission for those patients.

What is claimed is: 
     
         1 . One or more computer storage media storing computer-useable instructions that, when used by one or more computing devices, cause the one or more computing devices to perform a method, the method comprising:
 applying a readmission risk algorithm for each patient admitted to a healthcare facility;   responsive to applying the readmission risk algorithm to each patient admitted to the healthcare facility, identifying a subset of patients at risk for readmission;   generating a user interface to manage the subset of patients at risk for readmission; and   providing the user interface for presentation to a clinician.   
     
     
         2 . The one or more computer storage media of  claim 1 , wherein the readmission risk algorithm determines whether a patient is at risk for readmission based in part on the patient's length of stay satisfying a threshold length of stay. 
     
     
         3 . The one or more computer storage media of  claim 1 , wherein the readmission risk algorithm determines whether a patient is at risk for readmission based in part on a combination of the patient's age and social isolation of the patient. 
     
     
         4 . The one or more computer storage media of  claim 1 , wherein the readmission risk algorithm provides an indication for each patient as either a high risk for readmission or a low risk for readmission, and wherein the subset of patients at risk for readmission comprises patients determined as a high risk for readmission. 
     
     
         5 . The one or more computer storage media of  claim 1 , wherein the method further comprises suggesting a readmission prevention plan of care for each patient within the subset of patients at risk for readmission. 
     
     
         6 . The one or more computer storage media of  claim 1 , wherein the method further comprises identifying, for a first patient within the subset of patients at risk for readmission, one or more readmission risk factors for the first patient based on one or more algorithm criteria met for the first patient to cause the first patient to be determined to be at risk for readmission; and providing an indication of the one or more readmission risk factors within the user interface. 
     
     
         7 . The one or more computer storage media of  claim 1 , wherein the readmission risk algorithm is applied for each patient at a time of admission of each patient. 
     
     
         8 . The one or more computer storage media of  claim 1 , wherein the readmission risk algorithm is applied while each patient is admitted at the healthcare facility. 
     
     
         9 . The one or more computer storage media of  claim 1 , wherein the readmission risk algorithm is applied prior to discharging each patient from the healthcare facility. 
     
     
         10 . The one or more computer storage media of  claim 1 , wherein the readmission risk algorithm is applied after discharging each patient from the healthcare facility. 
     
     
         11 . One or more computer storage media storing computer-useable instructions that, when used by one or more computing devices, cause the one or more computing devices to perform a method, the method comprising:
 accessing patient information for a patient at a healthcare facility;   determining a risk for readmission for the patient based on the patient information and a readmission risk algorithm that is generic to patients admitted by the healthcare facility;   identifying the patient as being at risk for readmission based on the patient information and the readmission risk algorithm;   adding the patient to a subset of patients identified as being at risk for readmission; and   providing a user interface for presentation that identifies at least a portion of the subset of patients identified as being at risk for readmission.   
     
     
         12 . The one or more computer storage media of  claim 11 , wherein the readmission risk algorithm determines that the patient is at risk for readmission based in part on the patient's length of stay exceeding a threshold length of stay. 
     
     
         13 . The one or more computer storage media of  claim 11 , wherein the readmission risk algorithm determines whether that the patient is at risk for readmission based in part on a combination of the patient's age and social isolation of the patient. 
     
     
         14 . The one or more computer storage media of  claim 11 , wherein the method further comprises suggesting a readmission prevention plan of care for the patient based on identifying the patient as being at risk for readmission. 
     
     
         15 . The one or more computer storage media of  claim 11 , wherein the method further comprises identifying one or more readmission risk factors for the patient based on one or more algorithm criteria met for the patient to cause the patient to be determined to be at risk for readmission; and providing an indication of the one or more readmission risk factors within the user interface. 
     
     
         16 . The one or more computer storage media of  claim 11 , wherein the readmission risk algorithm is applied for the patient at a time selected from the following: a time of admission of the patient; while the patient is admitted at the healthcare facility; prior to discharging each patient from the healthcare facility; and after discharging each patient from the healthcare facility. 
     
     
         17 . A computerized system comprising:
 one or more processors; and   one or more computer storage media storing computer-useable instructions, that when used by the one or more processors, cause the one or more processors to:
 apply a readmission risk algorithm for each patient admitted to a healthcare facility, the readmission risk algorithm being generic to patients admitted by the healthcare facility; 
 responsive to applying the readmission risk algorithm to each patient admitted to the healthcare facility, identify a subset of patients at risk for readmission; 
 generate a user interface to manage the subset of patients at risk for readmission; and 
 provide the user interface for presentation to a clinician. 
   
     
     
         18 . The system of  claim 17 , wherein the instructions further cause the one or more processors to suggest a readmission prevention plan of care for a first patient from the subset of patients based on identifying the first patient as being at risk for readmission. 
     
     
         19 . The system of  claim 17 , wherein the user interface provides an indication regarding one or more risk factors causing each patient to be identified as being at risk for readmission. 
     
     
         20 . The system of  claim 17 , wherein each patient as identified as being at risk for readmission at a time selected from the following: a time of admission of each patient; while each patient is admitted at the healthcare facility; prior to discharging each patient from the healthcare facility; and after discharging each patient from the healthcare facility.