Transition Care Program (TCP) is a mobile text-based program designed to help patients manage their chronic disease following discharge from the hospital. SanusEO currently offers programs for the general population and disease-specific programs for Diabetes, Congestive Heart Failure (CHF), and just released in 2016, Joint Replacement.  These programs are designed to reduce hospital readmissions and improve patient outcomes.  Hospitals and payers both benefit from the implementation of the Transition Care Programs.

SSM DePaul JRC White Paper

Program Features:

Our Patient Engagement Platform (PEP) delivers patients daily text messages on their personal cell phone, with educational and supportive information that is client branded.  Based on patient responses the care team is notified for immediate and long-term intervention planning.

  • Interactive automated text messaging programs
  • HIPAA secure web portal
  • Red flag reporting tool
  • Disease specific messages
  • Patient progress tracking and reporting
  • Ease of implementation
  • Simple, secure, high impact for diverse patient populations

Benefits By Customer Type:

  •  Payers:
    • Reduces costs related to ER visits and hospital admissions
    • Engages  members and builds loyalty
    • Provides effective and proactive management of at-risk patients
    • Supports population care planning with access to program data
    • Offers HIPAA secure text messages and data platform


  • Hospitals:
    • Supports achieving National Quality Strategy Standards to reduce all readmissions by 20%
    • Minimizes potential CMS penalties, and denied reimbursements
    • Improves ability to identify and engage with at-risk patients
    • Engages patients with provider-branded text messages
    • Improves HCAHPS 5 star quality ratings including patient satisfaction
    • Delivers HIPAA secure text messages and data platform


  •  Patients/Participants:PaTIENT
    • Offers supportive and educational daily text messages for positive behavior modification
    • Provides convenient,  private, and engaging messaging delivered to their personal cell phone
    • Improves continuity of  care with  self-reported information enabling care team to track progress &intervene prior to a medical emergency
    • Supports healthy life styles and more productive lives
    • Reduces out of pocket healthcare expense

Coming Soon:  TCP Products for Lung Disease will be released in 2016!