Continuing Care
Care for patients across the continuum
Realize your vision for effective transitions of care and meet complex clinical and regulatory needs, wherever care is provided
In the Home
Provide your patients with the complete spectrum of care in the home: from low-touch self-monitoring with automatic escalation, to comprehensive remote monitoring programs, to certified home health and hospice, all the way to specialized programs like home infusion and home hospital.
In the Home
details →
Social and Community Care
Manage program enrollment and patients’ progress with centralized, shared tasks, multi-disciplinary care planning, care management assessments, program milestones, and scheduled outreach. For example, enroll patients in a transitional care management program before they leave the hospital to help avoid readmissions. Integrate social determinants of health into the EHR to connect patients to community resources and social services.
Social and Community Care
details →
Long Term Care
Help skilled nursing and long-term care clinicians provide high quality care and spend less time on documentation. Protect reimbursement during surveys and audits and use data from patient stays to improve outcomes.
Long Term Care
details →
Rehab
Use tools tailored to the unique clinical, regulatory, scheduling, and billing needs of inpatient and outpatient rehab settings. Leverage integration to more easily complete assessments for CMS, track therapy thresholds, and monitor patient progress.
Rehab
details →
Wound Care
Continuous wound monitoring across the spectrum of care, including inpatient encounters, outpatient wound visits, and post-acute care, can help patients heal faster and more effectively.
Wound Care
details →
Behavioral Health
Help providers support patients with mental health and substance use diagnoses across the full spectrum of care settings. Treatment planning and care coordination in a single patient record enables an interdisciplinary approach for the care team.
Behavioral Health
details →
Aiming for Zero: Providing Support to Children at Risk of Suicide
Aiming for zero suicides, MaineHealth improved its pediatric suicide prevention screening and more than doubled the volume of behavioral health consults to their children’s hospital units, connecting more youth to necessary treatment.
Apply →
Home Is Where the Care Is: Hospital-Quality Care in a Comfortable Home Setting
In one-and-a-half years, WellSpan’s hospital-at-home program accepted more than 800 patients, freeing up more than 1,500 hospital bed days and saving approximately $1.1 million.
Apply →
Addressing Social Care Needs in Partnership with Your Community
Since creating a hunger screening initiative to carry ProMedica's commitment to its patients' health and well-being beyond the walls of its hospitals and clinics, ProMedica has expanded their efforts to address additional SDOH domains. Overall, interventions coordinated through the Community Care Hub for all domains led to a 27 percent decrease in ED visits overall and a 33 percent decrease for the most vulnerable patients, a 21 percent decrease in hospital admissions, and an increase in per member per year (PMPY) costs of only 4 percent, as compared to 19 percent in a comparison group that didn't receive the interventions.
Read the full story from AJMC →
Neighborhood-Based Population Health Cuts Hospitalizations for Kids by One-Fifth
Cincinnati Children’s Hospital uses Epic to make life better for children facing health disparities.
Read the full story on Epic.com →
Roadmaps
See a high-level view of what Epic can do now, which new features are coming soon, and what the future holds.
Resources
Copyright © 2025 Epic Systems Corporation.