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EMRs reduced HF readmission odds
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A real-time electronic medical record-enabled strategy that targets high-risk patients with HF reduced the odds of readmission, according to findings from a prospective study.
“This is one of the first prospective studies to demonstrate how detailed data in electronic medical records 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,” Ethan Halm, MD, MPH, professor of internal medicine and clinical sciences and chief of the division of general internal medicine at UT Southwestern, said in a press release.
The software platform, developed by Dallas-based PCCI, stratifies patients admitted with HF by their 30-day readmission risk, as defined by a published HF readmission-reduction electronic model, according to the release. Patients at highest risk received intensive, evidence-based interventions designed to reduce readmissions using existing resources.
The researchers tested the electronic medical record (EMR)-enabled strategy in 1,747 adult inpatients admitted with HF, acute MI or pneumonia over 2 years at Parkland Memorial Hospital in Dallas. By using the real-time risk stratification program and concentrating intensive care management and cardiac resources on about one-quarter of the patients admitted with HF, researchers found a 26% relative risk reduction in the odds of readmission compared with a 21.1% reduction before the intervention was implemented (P=.01), and an absolute reduction of five readmissions per 100 index HF readmissions. The trend persisted in adjusted analyses (adjusted OR=0.73; 95% CI, 0.58-0.93), according to data in the abstract.
“[The strategy] reduced the population-based rate of readmission and saved the hospital thousands by redeploying limited, existing resources to the 25% of patients at highest risk. It was so successful that what started as a research project is now part of the way the hospital does business,” Halm said in the statement.
Readmission rates for acute MI or pneumonia did not significantly change during the study period.
Disclosure: The study was supported in part by grants from the University of Texas System Patient Safety Grant Award Program and The Commonwealth Fund. The researchers report no relevant financial disclosures.
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