Back in Action: Managing the Inpatient to Outpatient Transition in Post-Fracture

This episode of the Becker's Healthcare Podcast explores best practices for managing the transition of post-fracture osteoporosis patients from inpatient to outpatient care. Host Kristen Buseman, representing MGen, interviews Dr. Aloya Kramer from St. Elizabeth Healthcare and Jackie Kernahan from Mainline Health, both leaders in building specialized bone health programs. Dr. Kramer shares how her team at St. Elizabeth Healthcare created a 'Bone Health Clinic' within sports medicine to ensure rapid access and comprehensive care, while Kernahan details her 13-year journey at Crozier Health in establishing a Fracture Intervention Service that provides bedside consultations and seamless outpatient follow-up. Both emphasize the critical importance of continuity of care, naming their programs to reduce confusion and improve patient engagement. They highlight strategies like early inpatient education, pre-scheduling follow-up appointments, initiating prior authorizations during hospitalization, and using patient-facing materials to reinforce care pathways. The discussion underscores how low-cost, high-impact models can significantly reduce readmissions, improve treatment adherence, and lower long-term system costs. The episode concludes with a strong call to action for health systems to close the fracture care gap by adopting coordinated, patient-centered models. Key takeaways include the value of a single champion provider, the power of consistent naming for care programs, and the use of electronic health record tools to streamline referrals. The conversation also reveals that patients who experience continuity from hospital to outpatient care are more likely to adhere to treatment and avoid future fractures. With data from real-world programs showing measurable reductions in recurrent fractures and healthcare utilization, the episode positions coordinated post-fracture care as both a clinical imperative and a financial opportunity for health systems.