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Case Study

Reducing Heart Failure Readmissions by Solving for Social Determinants of Health

 

22% Reduction in Heart Failure Readmissions

Signify Community built a collaborative network of social and clinical service providers focused on solving social determinants of health (SDOH) and improving outcomes for 5,000 high-utilizers.

This Case Study will Highlight:

  • How Signify Community built a community-based care team that solved for SDOH like medication refill and transportation access
  • The privacy capabilities required to share information and generate longitudinal social records among cross-sector partners
  • How many SDOH-related activities were generated by users of the platform
  • The reduction in readmissions achieved in the first 2 years of the program, and how the outcomes improvement helped the hospital increase it's Heart Failure program ranking throughout the state

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