The transition from inpatient to outpatient status is a vulnerable spot in our health care system: more than one in four patients with congestive heart failure are back in the hospital within 30 days of discharge, and readmission rates for a host of other conditions are above 20 percent. The right improvements during this transition phase could have a profound impact, reducing the incidence and cost of unnecessary readmissions, and most importantly, improving outcomes for our patients. Dr. Harlan Krumholz, the Harold H. Hines, Jr., Professor of Medicine, Epidemiology and Public Health at the Yale University School of Medicine, talks with host Dr. Jack Lewin about the new Hospital-to-Home (H2H) initiative to lower rates of unneeded readmissions, and how the field of cardiology can contribute toward improving the hospital discharge process.