Use Cases/High-Risk Post-Discharge Follow-Up
High-Risk Post-Discharge Follow-Up

Focused follow-up on the patients who need it

Backline automates post-discharge outreach, captures patient responses, and routes identified needs to the appropriate care team for follow-up.

Teams see who has responded, who needs attention, and what follow-up is still outstanding.

POST-DISCHARGE · PATIENT B
Follow-up assigned
Patient discharged
Heart failure · high-risk follow-up
Automated outreach
Day 2 text check-in sent
Patient responds
“I haven’t been able to pick up my new water pill.”
!
Need identified
Medication access
Routed to care team
Pharmacy
✓
Follow-up
Pharmacist callback scheduled today

Turn patient responses into the next action

Backline Pathways initiates outreach at defined points after discharge and uses patient responses to move follow-up through a structured workflow.

Reach out automatically
Send defined post-discharge check-ins by text or voice.
Capture patient responses
Ask about symptoms, medications, appointments, or other recovery needs.
Route identified needs
Use defined workflow logic to route responses that require attention to the appropriate team or role.
Track follow-up
See outreach status, patient responses, ownership, and outstanding follow-up through completion.
‹
Patient D · Outreach
Day 3 check-in · text
Since leaving the hospital, is your shortness of breath better, the same, or worse?
Worse
Thank you. A nurse from your care team will call you today.
NEED IDENTIFIED
Worsening symptoms
ASSIGNED TO
Clinical RN
STATUS
Callback due
Accept follow-up

Bring patients who need attention into view

Not every patient response requires the same next step. Backline uses defined workflow logic to distinguish routine responses from those that require follow-up.

Outreach questions, response logic, routing, and follow-up workflows are configured around the organization’s process.

Post-discharge outreach sent
Patient responds
“Are you having trouble getting your medications?”
Need identified?
NO
Continue outreach
✓ Outreach complete
YES
Route to Pharmacy / Care Management
Follow-up assigned
✓ Follow-up completed

Make post-discharge follow-up easier to manage

Automate routine outreach

Reach patients at defined points after discharge without relying entirely on manual call lists.

Focus attention where it is needed

Bring patient responses that require additional follow-up into view for the care team.

Create clear ownership

Route identified needs to the appropriate team or role and show who owns the next step.

Keep follow-up visible

Track outreach, responses, assigned work, and outstanding follow-up in one workflow.

See who still needs attention

Give care teams a shared view of post-discharge outreach and follow-up across patients.

POST-DISCHARGE OUTREACH
4 patients · 3 need follow-up
PatientOutreachResponseFollow-up
Patient ARespondedNo needs identifiedComplete
Patient BRespondedMedication questionPharmacy follow-up
Patient CNo response—Second outreach pending
Patient DRespondedWorsening symptomsClinical follow-up

See how Backline fits your post-discharge workflow

We’ll map how patients are contacted, responses are reviewed, needs are routed, and follow-up is managed today and identify where Backline could create a more visible, structured workflow.

Schedule a Workflow Assessment →