EHR risk stratification can reduce readmissions

Real-time, electronic health record-based risk stratification can reduce hospital readmissions, according to a new study published online in BMJ Quality & Safety.

The study involved the examination of 1,747 adult inpatients with heart failure readmissions and other heart conditions over two years at Parkland Health and Hospital System, a 780-bed teaching hospital in Dallas.

The researchers used an EHR-based software platform to stratify all relevant patients admitted. The patients with highest risk received an intensive set of evidence-based interventions designed to reduce readmissions, using resources at hand.

The monthly post-intervention readmission rate was consistently below the pre-intervention average of 26.2 percent for 11 out of 12 months of the study. The authors concluded that an EHR-enabled strategy that targeted "scarce care transition resources" to high-risk heart failure patients significantly reduced the risk-adjusted odds of readmission.

"This is one of the first prospective studies to demonstrate how detailed data in EMRs can be used in real-time to automatically identify and target patients at the highest risk of readmission early in their initial hospitalization when there is a lot that can be done to improve and coordinate their care, so they will do well when they leave the hospital," said Ethan Halm, a senior author on the paper and professor of internal medicine and clinical sciences at the University of Texas Southwestern, in an announcement.

Emergency room access to a patient's medical history compiled through health information exchange reduced both readmissions and single-day admissions in a study from Israel.

Meanwhile, the use of predictive analytics and videoconferencing with nursing home staff reduced readmissions by 25 percent for El Camino Hospital, a 443-bed facility in Mountain View, Calif.

To learn more:
- read the study
- here's the announcement

Related Articles:
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Aetna: Case managers are 'cornerstone' of medical management
Readmission penalties trigger hospital improvements

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