"I think we in acute care don't speak the same language as a patient at home trying to take their medications," Riehle tells HealthLeaders Media. "We don't even call them the same things."
According to Riehle, the coaches help set up patient-specific programs for successfully caring for themselves at home, teaching them everything they need to know, from taking their medications correctly to helping them make follow-up appointments. They also teach patients how to monitor their own symptoms and solve problems based on what they're experiencing.
"Whatever their condition is, [they learn] the top things that they need to be looking for that they need to call their doctor about," Riehle says.
She adds that in addition to preventing readmissions, the program aims to teach patients to be proactive in their own healthcare, helping them do things for themselves.
"At the end of that 30 days, the patient is better able to manage their own healthcare," she says.
So far, so good.