Better connected care through discharge manager software

The Discharge Manager is a digital tool developed by "Verbund Pflegehilfe" to seamlessly transfer patients from hospital to follow-up care. The digitalization of communication between social services and follow-up care providers speeds up the transfer and discharge of patients. As a supplement to the hospital information systems (HIS), the software saves time and personnel.

"We now work with over 45,000 providers and 317 registered clinics," reports Johannes Haas, Managing Director of the Nursing Aid Association. The Discharge Manager was developed from practical experience. In 2017, hospitals were legally obliged to ensure seamless follow-up care for patients. "The manual organization of follow-up care is extremely time-consuming," says Haas, which can easily lead to excessive demands on staff. Thanks to an intuitive user interface, the right follow-up care provider can now be found with just a few clicks.

"The software was a logical further development for us, as our company already has extensive expertise in the field of nursing and aftercare with the nursing assistance network," reports the Managing Director. Before the software was used, the search in the clinics for suitable aftercare providers as part of connected care often took days or weeks, says Haas.

The software can be used nationwide. The follow-up care network is particularly well developed in the federal states of North Rhine-Westphalia, Bavaria and Baden-Württemberg. The service, including the further development of the software and the expansion of the network, is financed by a monthly fee, the amount of which depends on the size of the facility. In addition, a flat fee is charged for connecting the HIS to ensure seamless integration into the existing systems. This reduces duplicate entries and errors and improves efficiency, says Haas.

A speedy discharge process helps to avoid unnecessarily long hospital stays. The appropriate follow-up care often involves outpatient or inpatient care and proves to be a challenge, especially in regions with a shortage of specialists. Hospitals expect user-friendly software that can be seamlessly integrated into existing systems and simplifies the discharge process, with data protection also playing an important role.

The Discharge Manager with interface to the HIS has been in use at Klinikum Altenburger Land since October 2024. In addition to the rapid connection of the aftercare provider, which is intended to create free consultation capacities in the social services department, data protection requirements played a particularly important role.

IT manager Reiner Selent reports that the interface required on the HIS side was implemented in-house and information was added: "Using a set of rules agreed with our social services department, we determine further required information such as diagnoses, relatives and GPs in order to automatically transfer this to the discharge manager," he describes the procedure.

Certain digital documents, such as the current nationwide medication plan or the care transfer sheet, are also transferred based on rules. The results of the requests are archived in the HIS: "In the end, we have established a lean process and the process has also become much simpler for the follow-up care providers."

Nicole Baum, Head of Patient Services at Klinikum Altenburger Land, highlights another advantage: "Thanks to digital discharge management, we receive prompt feedback from several providers at the same time. We always discuss this with the patients and their relatives and can therefore take individual wishes into account even better. The digital system also proves its worth if you are searching in a region that is very far away from your own and where you don't have a contact person."

She describes the collaboration with the software developer as very positive: "Our concerns are dealt with promptly and we work together to find solutions to problems." In addition, efforts are being made to intensify the use of connected care: "In future, we also want to use the option of electronically arranging discharge trips to various providers directly from the ward in order to avoid time-consuming telephone calls."