The Client
Our client is a provider of technology services to Skilled Nursing Facilities (SNF).
The Challenges
Our client’s goal was to help Skilled Nursing Facilities (SNF) remain competitive with other SNF’s by efficiently and strategically admitting patients. To achieve this goal, the SNF’s had to overcome two essential challenges:
- A multi-format referral process that often slows admissions
- The expensive outcome of admitting the wrong type of patient
Every day, referrals were arriving in various formats—fax, email, and EMR portals, some even as 70-page PDFs that required manual review. This onslaught of paperwork slowed decisions. While the SNF wanted to remain competitive by admitting patients efficiently, they didn’t want to make an admissions error. Admitting a patient whose health needs could not be sufficiently met by the SNF can lead to poor health outcomes, hospital readmissions, penalties, and reimbursement issues.
Continuing to face these challenges without a solution meant the potential loss of patients to other facilities, and consequently, loss of business and revenue.
To build a solution, our client reached out to our team at Clinovera, the healthcare division of First Line Software.
The Solution
The Clinovera team collaborated with the client's dev team to implement an AI solution that integrated into the client’s Smart Admission’s platform. As the user feedback grew, Clinovera and the client continuously adapted the solution’s functionality and structure.
How Clinovera Tackled the Problem
- Automated Intake: Seamlessly captures unstructured data—faxes, PDFs, scans, plain text—from EHRs and referral sources.
- Patient-Centric Document Handling: Groups documents by patient and uses AI to extract critical clinical information.
- Structured Data Conversion: Transforms extracted data (demographics, diagnoses, meds, insurance) into the client’s proprietary format for streamlined storage and use.
- Insight Generation for Admission Decisions: Produces key metrics like NTA scores, medication costs, and red-flag alerts (e.g., high readmission risk) to support timely, informed placement.
- Cost-Efficient AI: Optimizes performance and cloud spend using smart document chunking, embeddings, and vector search.
- Multi-Model Flexibility: Orchestrates OpenAI, Azure, and open-source models for cost-effective, vendor-agnostic scalability.
- Smart Prompting Engine: Summarizes documents and surfaces high-value data instantly; auto-augments user prompts for better AI responses.
- Seamless Integration: Connects easily with existing systems via a custom API.
Business Impact
Since its original implementation, this solution has been implemented and deployed at several SNFs, drawing praise from both users and SNF leadership:
- Operational Uplift: Live pilots show faster workflows, reduced staff burnout, and more time redirected to high-value care coordination.
- Smarter Admissions: Quicker, more accurate decisions improve placement quality and reduce inappropriate admits.
- Stronger Financial Outcomes: Faster referral conversions and early capture of high-reimbursement codes (e.g., CPT, NTA).
- AI That Supports People: Frees clinicians from paperwork—keeps the human touch front and center.
- Scalable Growth Path: EHR and system integrations underway to enable fully automated, low-touch referral-to-admission workflows.
If you’re curious how Clinovera could help your healthcare operation become more efficient and mission-driven, click here to schedule a consultation.
