The transitionist will see you now
In 1996, Robert M. Wachter and Lee Goldman, MD, introduced the term "hospitalist" in an article published in the New England Journal of Medicine. This concept responded to the urgent need for specialized physicians to manage patient care during hospital admissions, shifting responsibilities away from primary care providers who traditionally rounded on their patients in inpatient settings. Over time, the hospitalist model has become integral to healthcare delivery in the United States, allowing for improved efficiency in patient care amid evolving hospital compensation structures.
By the early 2000s, the hospitalist specialty witnessed remarkable growth, effectively replacing the practice of primary care physicians managing hospitalized patients. This model has been remarkably successful, but the resulting care gap, between the discharge and follow-up with primary/specialty care, has continued to widen along with evolution of healthcare culture, bandwidth, and economics.
To address this challenge, Dimer Health has introduced a pioneering practice focused on transitional medicine, conceptualizing the term “transitionist” to represent this emerging specialty.
Introduction
Historically, the management of hospitalized patients involved the active participation of primary care physicians who performed rounds in hospitals rather than specializing in inpatient care. This traditional model faced significant inefficiencies, particularly in light of evolving hospital reimbursement models that necessitated greater efficiency in patient management and length of stay. The emergence of hospitalists transformed this landscape, leading to a well-defined role for physicians specifically focused on hospital care.
Today, as healthcare systems continue to adapt, the significance of transitional care has come to the forefront. The pressures for rapid patient discharge and the complexities of care continuity call for a novel approach to patient management following hospitalization.
By leveraging existing insurance structures aligned with virtual office visit codes, we maintain positive economic viability while delivering essential patient care. We anticipate that transitional medicine will emerge as a standard component of post-acute care, and we aim to lead the advancement of this vital field.
- Steve Jobs
The Need for Transitional Medicine
As healthcare providers strive to meet the rising expectations of patients—who increasingly seek timely care within the comfort of their homes—the absence of dedicated transitional care resources has become evident. Patients discharged from acute care settings often find themselves without adequate follow-up, leading to increased rates of emergency room revisits and hospital readmissions.
Dimer Health was founded on the premise that a specialized focus on transitional care is essential in today’s healthcare environment. The transitionist role is designed to bridge the gap in continuity of care, ensuring that patients receive timely, proactive follow-up after discharge.
Innovative Model of Care
At Dimer Health, we have developed a model where technology and physician expertise converge to enhance transitional care delivery. Within 24 to 72 hours post-discharge, patients are facilitated with virtual visits, allowing them to address questions and concerns in a timely manner. This ongoing proactive care model aims to support patients until they can comfortably transition back to their primary care providers or specialty care teams.
Our commitment includes 24/7 availability, ensuring that patients can access care as needed, thereby reducing anxieties associated with post-discharge management:
Outcomes and Future Perspectives
Analysis of our service delivery in New Jersey and New York has indicated promising outcomes. Patients engaging with Dimer Health’s transitional services have experienced a notable 68% reduction in emergency room revisits and hospital readmissions. Furthermore, with a net promoter score (NPS) of 95, our model demonstrates strong patient satisfaction and engagement.
By leveraging existing insurance structures aligned with virtual office visit codes, we maintain positive economic viability while delivering essential patient care. We anticipate that transitional medicine will emerge as a standard component of post-acute care, and we aim to lead the advancement of this vital field.
Conclusion
As we navigate the complexities of modern healthcare, the introduction of transitional medicine represents a critical evolution in the approach to patient discharge and ongoing management. Dimer Health is at the forefront of this transformation, committed to reshaping the way care is delivered in the post-acute setting, thereby enhancing outcomes and patient satisfaction. Our vision is to establish the role of the transitionist as a cornerstone of future healthcare delivery models, addressing the unmet needs of patients in a rapidly changing healthcare landscape.
