Follow-up after discharge for your patients.
Maintain structured follow-up after hospital discharge and identify the patients who need additional clinical attention.
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THE SOLUTION
Engage patients at key moments and alert care teams when clinical review is needed.
A defined follow-up window
Contacts begin once the patient leaves hospital and follow a schedule set for the pathway. The focus is recovery after the acute episode, not ongoing monitoring of the underlying condition.
Symptoms and recovery at home
Each contact collects how the patient has been feeling since leaving hospital, alongside symptoms, warning signs and home measurements included in the protocol.
Medication and treatment changes
Contacts check whether the patient has started the medication prescribed at discharge and is taking it as indicated, and record any questions about changes to their treatment, which are passed on to the care team.
Review, alerts and closing the episode
Responses outside the protocol’s criteria generate alerts, and the care team decides the next step. Each review is documented with a clinical note and the care plan. When the window ends, the team closes the episode or refers the patient to their usual care or to a long-term programme.
Protocols for diferent types of discharge
Protocols grounded in clinical practice guidelines and refined across previous implementations.
Wrist osteoarthritis follow-up after discharge
Assesses health status after hospital discharge in patients with wrist osteoarthritis.
Urinary tract infection symptom monitoring
Identifies signs and symptoms suggestive of a urinary tract infection.
Knee osteoarthritis follow-up after discharge
Assesses health status after hospital discharge in patients with knee osteoarthritis.
Postnatal follow-up
Contacts the patient after childbirth to record her recovery and answer questions.
Frailty follow-up after hospitalisation
Follow-up of patients with frailty after a hospital stay.
Follow-up after an A&E visit
Records the patient’s progress after an A&E visit and answers questions covered by the protocol.
Heart failure follow-up after discharge
Follow-up after discharge to identify signs of worsening and help prevent complications or readmissions in patients with heart failure.
RESULTS
Continuity in follow-up. Evidence from patient outcomes.
-19.6%
hospitalizations compared with the previous period in the same COPD patient population.
Post-discharge follow-up helps care teams monitor patient progress and identify cases requiring additional attention.
Reduced hospitalizations after discharge
94.1%
reach and engagement per contact, across 4,011 contacts with 877 patients.
Autonomous follow-up at weeks 1, 2 and 4 keeps patients connected to their care teams after discharge.
High Patient Engagement through recovery
Success stories
A selection of the success stories of this solution.
Success study
Patient reach and engagement with clinical AI Report
94.1%
Reach and engagement
Success study
Reducing heart failure readmissions
54.69%
Reduction in Heart Failure Readmissions
Success study
Expanding nursing capacity in post-infiltration follow-up
4x
augmented nurse capacity from post-infiltration follow-up
Success study
Reducing COPD hospitalizations
19.6%
hospitalization reduction
Success study
Increasing post-emergency follow-up response rates
+37,8%
Increased response rate
“Since we started using LOLA, hospital admissions for acute deterioration have been avoided in 6 out of 10 cases. It helps us reach a broader patient population with the same team and anticipate when a condition may worsen.”
BENEFITS
The value of follow-up when patients return home
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CONTINUITY
Continuity of care outside hospital
Patients can share how they are doing during follow-up, without waiting for their next face-to-face appointment.
PATIENT-FIRST
Care focused on patient needs
Prioritisation helps the team organise its review around reported issues and decide what care each case needs.
CAPACITY
More capacity to maintain planned contact
Scheduled contacts and repeat attempts increase the opportunities to reach patients throughout the programme, without relying on a single attempt.
RELATED SOLUTIONS
Discharge is one step in the pathway, not the end
ACUTE EPISODES
Preparation for tests and surgery
Before the same procedure: patients arrive prepared and procedures are not cancelled.
follow-up
Chronic and long-term care
When the post-discharge period ends and the patient needs ongoing follow-up.
administrative
Access and demand management
Reviews arising from follow-up are booked, confirmed and rescheduled without going through the team.