Transitions of Care (Remote Patient Monitoring)

A mom snuggles her newborn while talking with a provider on her laptop.

We offer advanced clinical technical to support patients as they transition from the hospital to their next care setting. Whether they go home, to assisted living or to a skilled nursing facility, we make the change easier and safer.

Our remote patient monitoring programs can:

  • Allow patients to safely go home sooner.
  • Reduce complications during recovery.
  • Improve the patient experience as they recover in a more familiar setting.
  • Improve clinical outcomes as we identify concerns or set-backs sooner.
  • Prevent readmissions to the hospital.

Transitions of care programs

Patients in each of these programs go home with remote monitoring devices, tablets or other hardware to easily share data and communicate, and clear goals for their recovery. We connect with their community primary care provider or specialists whenever possible.

Newborns working on feeding skills

This program is for newborns who are in the OHSU NICU due to feeding concerns alone (no breathing or temperature control concerns). Our remote patient monitoring program lets these babies go home with their parents an average of 11 days sooner.

We give parents a communications device where they report what their baby eats, voids and weighs. Parents can also ask questions or report concerns directly to our neonatology team.

Pediatric congenital heart defects

Newborns and other young children recovering from heart surgery go home with monitoring devices and a communications device. Recovery data goes directly to our pediatric cardiology team, and parents can ask questions and report concerns quickly and easily.

Adult recovery

Patients recovering from certain conditions or surgeries can leave the hospital sooner through this program. Each patient has a dedicated care manager who monitors them for 90 days before, during and after their hospitalization. The care manager:

  • Monitors their recovery, including vital signs and therapeutic progress.
  • Provides tools and advice to help patients stay on track.
  • Answers questions and addresses concerns quickly.
  • Responds to concerning symptoms or disengagement with the program to keep patients safe.

Remote patient monitoring is available for some patients recovering from hip or knee replacements.

Contact us

We will respond within two business days to:

  • Answer your questions
  • Set up a virtual or in-person meeting
  • Arrange a demonstration

Contact information:

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