Bridging the Divides
Bridging the Divides (Bridges) is a care management program focused on helping patients with ischemic heart disease transition successfully from hospital care and improve their long-term health. Christiana Care Health System will work closely with community doctors and specialists to support patients in the Bridges program for at least one year after they are discharged from the hospital.
A core component of the program is improving the technology infrastructure to make data from clinical sites more available to the providers caring for each patient. The new system will incorporate data from many places that patients receive care, including:
Inpatient and outpatient electronic medical records from primary care and specialty physicians
Statewide lab and hospital use information from the Delaware Health Information Network (DHIN)
This program is supported by a Health Care Innovation Award from the Center for Medicare and Medicaid Innovation.
The Bridges team will use this data to support evidence-based care that is coordinated among all of the patient’s clinical care providers. The goals of the program are to improve the delivery of evidence-based care tailored to each individual patient, resulting in better health, better health care and lower costs.
The project described was supported by Grant Number 1C1CMS331027 of the Department of Health and Human Services, Centers for Medicare & Medicaid Services.
The contents of this webpage are solely the responsibility of the authors and have not been approved by the Department of Health and Human Services, Centers for Medicare & Medicaid Services.