Improving Health Care Quality Through Electronic Health Records

In this post, I would like to share a video I watched recently which examines the use of Electronic Health Records (EHRs) to improve quality of healthcare. The video- posted by HRSA- is fairly long but also very informative. Enjoy it.

Can Information Technology Improve Readmission Rates?

Source: Vital Partners

Many factors have been found to be associated with readmissions according to a study done by Allison Nudge and colleagues in Australia.  The authors showed a correlation between readmissions rate and factors like co-morbidities, nutritional status and mood  of the patients. They studied patients with chronic conditions who had two or more admissions in six months. The rate of readmissions is an important issue for hospital administrators and policy makers because of their relationship to increasing costs, especially in health systems that use the DRG (Diagnosis Related Group) payment system like the United States.

It is within this backdrop that I discuss the ability of information technology to help solve or at least, reduce this problem. Carol Everhart, in an article published online in Pharmacy Choice, opined that hospitals should pay attention to the particular reasons why individual patients are returning to the hospital after being discharged home and not focus solely on aggregated hospital data.

How can hospitals do this? It is obvious as shown in Nudge's paper, that one readmission drastically increases the risk for repeat readmissions as well as other factors she described. Granted, there is not much that can be done by physicians without electronic medical records and so, my suggestions are going to be based on situations where there are clinical decision making tools like CDSS (for an understanding of this, see my previous posts).

Is it possible to write a program such that the presence of these risk factors for readmissions are coded in the electronic medical records and a warning system is put in place such that the physician in charge is able to activate an anti-readmissions protocol which can help reduce the likelihood of another readmission? By all indications, this is possible and I am almost sure that this is been put in place somewhere. If you have an idea of where this occurs, please let me know.

We would do well to note that many factors that predispose to readmissions are not known at the time of discharge and consequently, cannot be predicted. However, most of them are known and the patient can benefit from these interventions which can also help the hospital save costs. Will these technological innovations be useful for preventing readmissions that are due to nutritional problems or mood/ psychological imbalances as discussed by Nudge et. al? I guess we just have to keep our fingers crossed.

In my next post, I will report such technological innovations and where they are being put into use.

Readmissions is a very exciting area that I look forward to exploring going forward.