Voice-led, omnichannel by design. One conversation, one record, whatever channel the patient chooses.
When a patient moves between settings, discharge to home, hospital to specialist, specialist back to PCP, responsibility blurs. The follow-up appointment is not booked, instructions are not confirmed, and the patient either drifts out of the network or returns through the most expensive door. The coordination work is real, and there is rarely anyone with time to own it.
This is the same Steer cycle, capture, book, collect, return, applied to the handoffs between care settings. Steer manages the operational follow-through, not the clinical decisions.
Post-discharge and post-visit outreach happens within hours, confirming instructions and surfacing problems early.
The next appointment is scheduled before the patient leaves the loop, not weeks later when it is too late.
Referring and receiving providers are kept informed, so the handoff is tracked end to end.
Proactive follow-up identifies the issues that would otherwise become an avoidable readmission.
The transition no single team owns, tracked and closed.
Post-discharge contact while it still changes the outcome.
One record follows the patient from hospital to home to clinic.
Modeled on a coordinated care network.
follow-up appointments completed
avoidable readmissions
network leakage
“Steer connects every step into one system, so a patient leaving one setting is never dropped before they reach the next.”
Steer remembers every patient across every interaction, so each step hands off to the next. Capture leads to booking, booking to documentation, documentation to recall. One system that finishes the job, instead of point tools that forget the patient in between.
About discharge follow-up, care transitions, and readmission reduction.
AI care coordination uses autonomous agents to manage the patient transitions that fall between clinical settings — from hospital discharge to follow-up appointment, from specialist visit back to the PCP, from surgery to post-op recovery. Steer Health's Honi agent handles 10,000+ daily patient check-ins automatically, achieving 42% hospital readmission reduction and 89% medication adherence across live deployments.
Steer Health's Honi agent contacts patients within 24 hours of discharge via personalized voice call or SMS — confirming they have their medications, answering questions, detecting early warning signs that require intervention, and scheduling follow-up appointments automatically. This prevents the care fragmentation that leads to avoidable readmissions and achieves a 42% readmission reduction across live hospital deployments.
Steer Health coordinates every major care transition: hospital discharge to follow-up care, emergency department visit to primary care or specialist, surgical procedure to post-op recovery and physical therapy, specialist visit back to referring PCP, and chronic care management check-ins for high-risk patients. All coordination is handled by Honi automatically — no manual care coordinator effort required.
Healthcare's most expensive failures happen between settings — between the hospital discharge and the follow-up appointment, between the specialist visit and the PCP update, between the procedure and the post-op recovery check. These transitions are where readmissions are born, where medication errors accumulate, and where care plans are abandoned. Steer Health's Honi agent was built for exactly this gap: autonomous care coordination at every transition, at scale.
Honi contacts every patient within 24 hours of discharge via personalized voice call or SMS — confirming they have their medications, answering questions, detecting early warning signs, and scheduling follow-up appointments automatically. Across live hospital deployments, this achieves a 42% readmission reduction. The care fragmentation that drives avoidable readmissions is addressed at the moment patients are most vulnerable — the first 24 hours after discharge.
Honi handles 10,000+ daily patient check-ins across live deployments — post-discharge calls, chronic disease management check-ins, post-operative recovery monitoring, and care gap follow-up — entirely automatically. Every check-in is personalized from the patient's record. Patients who need intervention are flagged immediately. The coordination volume that would require dozens of staff to manage manually is handled by a single AI agent at scale.
Medicare penalizes hospitals for excess readmissions under the Hospital Readmissions Reduction Program — and those penalties compound across every readmitted patient. Steer's Honi agent directly reduces the 30-day readmission rates that trigger HRRP penalties, achieving $1.8M in penalty avoidance across live hospital deployments. The ROI on care coordination automation is measurable, immediate, and tied directly to reimbursement outcomes.
Honi monitors medication adherence through automated check-in calls and SMS — confirming patients have filled prescriptions, identifying barriers to adherence, and flagging non-adherent patients for clinical follow-up. Across live deployments, medication adherence rates reach 89%. The adherence failures that lead to chronic disease complications, emergency department visits, and avoidable hospitalizations are caught before they cascade.
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