Particle Signal for Transitions of Care

How Optimizing Transitions of Care with Signal Alerts Benefits Patients, Providers and Payers

Transitions of care — moments when a patient moves from one healthcare setting to another — are among the most vulnerable and costly points in the patient journey.

For example, at an average cost of $15,000 each, hospital readmissions account for more than $26 billion in Medicare spending each year. In fact, according to the Centers for Medicare & Medicaid Services (CMS), nearly one in seven Medicare patients discharged from a hospital is readmitted within 30 days, often due to poor communication or lack of follow-up care.

Why Transitions of Care Break Down

Transitions of care can be confusing and stressful for patients. When they lack information, they may miss follow-up appointments, struggle with medications or disengage from their care.

Incomplete or delayed records, inadequate post-discharge care, and even lack of visibility into the fact that a transition has occurred can stand in the way of care continuity and patient support.

The Value of Improving Transitions of Care

On the other hand, equipping compassionate providers with the actionable information they need to engage patients and caregivers in collaborative discharge planning may lead to improved patient outcomes and decreased cost of care.

The Standard Solution? ADT Feeds.

One of the most widely used tools for supporting transitions of care are ADTs, or Admission, Discharge and Transfer data feeds. Triggered by patient encounters, these feeds provide real-time notifications, including basic information, such as patient demographics, event details and, in some cases, the reason for a visit or diagnosis.

In turn, ADT alerts often trigger care coordination workflows such as post-discharge follow up, medication reconciliation and referral support. But, while useful, ADTs alone are not sufficient for empowering care teams to optimize transitions of care.

Where ADT Feeds Fall Short

Inconsistent coverage: Providers may receive ADTs through individual hospital integrations, Health Information Exchanges (HIEs), or aggregators that bundle feeds at local or regional levels. Whatever the case, the result is often a patchwork network that covers only a portion of hospitals in most states.
Poor data standardization: Additionally, ADT customers must reconcile and normalize data formats. Because the data received differs widely by source, the information can be inconsistent and incomplete, creating workflow friction and reducing alert usability and trust.
Incomplete clinical depth and context: ADT notifications don’t often capture discharge summaries, procedures, labs, vitals or medication lists — or provide the comprehensive, longitudinal patient history necessary for clinical decision-making.

ADT feeds were an important first step in giving care teams visibility into patient movement across care settings. But comprehensive care coordination demands more.

Enter Signal Alerts from Particle.

Particle Health’s Signal offering is designed to address the limitations of ADTs and transform the way organizations navigate transitions of care.

Signal doesn’t simply alert care teams to patient movement. It delivers the nationwide coverage and clinical context care teams need to proactively support patients and their caregivers:

Coverage: A Single, Nationwide Solution — Not a Patchwork

In a direct comparison for a VBC provider using 6+ ADT feeds — including an aggregator and multiple state HIEs — Signal identified nearly 25% more inpatient and emergency events than standard ADTs.
Signal is built on a national network across the majority of CMS hospitals and extensive SNF facilities. This comprehensive coverage provides access to 320M+ patient medical records — all via one connection.

Context: Trade Basic Alerts For Deeper Understanding

Instead of waiting days for discharge documentation or calling for records, care teams receive a timely, contextualized view of each patient’s clinical status:

Each Signal notification is enriched with structured, clinical context, including procedures, medications, discharge summaries, and follow-up instructions.
Signal associates clinical metadata with episodes of care, removing the need to piece together information from multiple sources.
Longitudinal data is accessible through the same platform, so care teams have the historical patient journey in view.
Particle’s AI surfaces insights such as summaries of visits, previous hospitalizations, medication changes and eligibility for care management programs.

The result is comprehensive and actionable insight into the event, plus relevant patient history, delivered in near-real time.

Actionability: From Reactive to Proactive Care

Coverage and context only matter if teams can act on them — and Signal was built for action. With Signal, care teams can lean on parsed, curated outputs while focusing on their patients.

Take Medication Reconciliation, for example. With Signal, care teams can simply:

Reference medication changes directly in the alert’s linked discharge summary
Further contextualize the changes by referencing parsed conditions, procedures, and lab results
Get highlighted encounter and/or patient-level details, such as encounter-level medication summaries, thanks to AI-powered insights

Additional actionability benefits:

The depth and breadth of clinical data on the national networks make Signal particularly effective for monitoring patients at scale.
No heavy integration required. Signal alerts mirror the structure of ADT feeds, fitting seamlessly into existing workflows.

With access to near-real-time health records, discharge summaries and care plans, providers can act quickly on complete information rather than delaying care or supporting patients without the pertinent context. Closing care gaps can not only improve patient outcomes, but also strengthen payer contracts, raise performance scores and drive financial upside.

In Closing

Transitions of care may continue to be complex. But with Signal they no longer have to be blind, fragmented or reactive. By enriching ADT alerts with deep clinical insight or replacing them completely, Particle Health empowers care teams to move from standard alerts to differentiated insights and true actionability.

Signal provides a smarter foundation for continuity, quality and trust across the care continuum. Coverage care teams can rely on. Context that adds meaning. Actionability that supports outcomes.

Contact Particle to learn how we can help you transform transitions of care, one signal at a time.