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CROM™

Comprehensive Respiratory Outcome Management

is Alana’s proprietary health management program for respiratory patients, designed to break the cycle of failed care by rehabilitating recently hospitalized patients and preventing readmissions and, where possible, preventing hospitalizations altogether.

Click below to learn how Alana is identifying and bridging critical gaps in patient care.


Chronic respiratory diseases account for a disproportionally large portion of health care utilization. Chronic obstructive pulmonary disease (COPD) alone is the only major fatal illness in which the age-adjusted mortality rate is increasing, growing by 283% between 1979 and 2007.

In 2010 the total annual cost of COPD was an estimated $49.9 billion, exceeding those associated with heart failure. Health care utilization is approximately 2 to 3 times higher for those with COPD, seen in hospitalizations, emergency department admissions and outpatient encounters.

Hospitalizations and hospital readmissions account for more than 25% of the total cost each year.

The 30-day hospital readmission rate for COPD patients is approximately 25%, among the highest in the nation, and accounts for 41% of all hospital readmissions. Thirty-day readmissions for COPD as a primary diagnosis are 18% higher in cost than the original index admission and 50% higher for readmissions with COPD as a primary or secondary diagnosis. For the most severe patients, readmission length of stay (LOS) is twice as long (8 days) and results in 10 times higher mortality rates.

Exacerbations, or flare-ups, are the primary cause of hospitalizations amongst COPD patients. When Patients experience an exacerbation, the most common reaction is to make their way to the emergency room or doctor’s office. They are treated with steroids, medications, non-invasive ventilation (BIPAP), and in cases of respiratory failure, mechanical ventilation. Shortly thereafter they begin to feel better and are discharged home.

Rarely is anything ever done to address the cause of the exacerbation, or to prepare patients with resources to better manage their exacerbations. This is a failed cycle of care.

In order to effectively and efficiently care for COPD patients, the patient needs must be
addressed proactively.

CROM™ utilizes experienced respiratory therapists to work with patients and their providers in creating a new culture of patient-centered care, through therapy management, education and outcomes. The therapist and patient build a foundation for education, shared responsibility and therapy adherence.


CROM™ patients experience a combination of the most innovative and effective practices in:

– Pulmonary Health Management
– COPD Symptom Management
– Behavior Modification / Smoking Cessation
– Medical Device Therapies

Evidence – Based
Studies have shown that integrated patient care for GOLD stage III and IV COPD patients can result in a 57% reduction in hospital ED admissions, 59% reduction in hospital admissions, 39% reduction in unscheduled general practitioner visits, 73% reduction in general practitioner visits, 20% increase in medication adherence, and a 10% improved pulmonary gas exchange.

Respiratory therapists serve as better breathing coaches to deliver CROM’s high-touch patient care.

They provide:

– Clinical Assessments (Disease Status, Environmental, Care Coordination, Care Pathway)
– Patient Education
– Therapy Training & Adherence Coaching
– Outcome Monitoring & Reporting

CROM™ engages in three information/communication activities of importance: collection, adherence/quality control and dissemination.

CROM™ tracks and reports quality of life indicators for patients, satisfaction indicators for providers and health care utilization indicators for payers. Our respiratory therapists deliver CROM™ reports each month to all stakeholders in the patient’s continuum of care.

CROM™ respiratory therapists and patients work together to identify when they feel well, not so well, when an exacerbation is likely to occur, and, how to address each.

CROM™ educates and equips each patient with tools for the preventive or responsive management of COPD and related exacerbations/symptoms. Doing so prepares our patients to better self-manage their disease process, reducing the need for acute re-hospitalizations.