Readmission Prevention

Catch deterioration before the patient calls the nurse line.

The 30-day readmission window is the most expensive gap in chronic care. Lyra Alert Engine detects multi-signal deterioration patterns up to 48 hours before clinical thresholds are breached.

Abstract clinical alert visualization — early warning signal emerging from patient vital data patterns
The Problem

30-day readmissions cost health systems more than clinical staff hours

A preventable 30-day readmission costs a health system $15,000–$25,000 in direct care costs — and potentially more in CMS penalty exposure under the Hospital Readmissions Reduction Program (HRRP).

The majority of preventable readmissions in chronic disease populations follow a detectable deterioration pattern. Glucose climbs over 3–4 days. Blood pressure builds. Weight creeps up two pounds, then three. The care team doesn't see any of it — until the patient is back in the ED.

$15K–25K Cost per preventable readmission
~20% Medicare patients readmitted within 30 days
48h Target early detection window before threshold breach
3–5d Fluid retention pattern detectable before heart failure decompensation
Lyra Alert Engine

How Lyra detects multi-signal deterioration

Signal Weighting

Glucose trend, BP variability, and weight delta are combined into a composite risk score. Alerts require confirmation across multiple signals, not just a single elevated reading.

Temporal Acceleration

Lyra weights trend acceleration — a glucose reading of 160 rising from 110 over 3 days scores higher than a stable 160. The rate of change matters more than the absolute value.

Stratified Alerts

Red (act within 4 hours), amber (outreach today), and green (monitor, no action). Care coordinators start their day at the top of the red list — not scrolling 800 patients.

Alert Timeline

48-hour deterioration alert progression

This mock timeline shows a synthetic patient deterioration pattern — how Lyra surfaces the signal before the threshold breach.

Patient PT-4821 — Deterioration Alert Sequence HIGH RISK
TimestampGlucose (mg/dL)SBP (mmHg)Weight (lbs)Lyra Status
Jun 8 · 07:15 118 132 186.0 Normal
Jun 9 · 07:22 149 138 186.8 Watch
Jun 10 · 07:18 181 146 187.6 Amber Alert
Jun 11 · 07:09 234 152 189.2 Red Alert
Jun 11 · 08:14 Care coordinator called patient → adjusted insulin protocol Outreach logged

Synthetic patient data for illustration purposes only.

Get Started

See how Lyra would work for your highest-risk patients.

We'll walk through your current readmission rates and show where RPMLyra closes the monitoring gap.