Researchers study results of web-based communication between hospital, dialysis facilities
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Researchers tested a web-based communication platform between a hospital and dialysis facilities to reduce 30-day hospital readmissions but found no statistical significance between readmission rates before and after implementation.
“Patients receiving dialysis spend a lot of time in the hospital, and they are often hospitalized again within 30 days of discharge,” Laura C. Plantinga, PhD, from the department of medicine at Emory University School of Medicine, and colleagues wrote. “Improving communication between providers at dialysis facilities and hospital[s] could help improve coordination of care of dialysis patients who are hospitalized, ultimately improving outcomes.”
In a pilot pre-post study, researchers introduced DialysisConnect to Emory University Hospital Midtown (EUHM) and four affiliated Emory Dialysis facilities, which despite the affiliation, do not share health care management or an electronic health record. As Healio reported previously, the web-based communication platform DialysisConnect was designed to close the communications gap between dialysis facilities and hospitals.
In this study, Plantinga and colleagues sought to determine if using DialysisConnect would reduce 30-day hospital readmissions among Emory Dialysis patients who were admitted to EUHM.
Between Jan. 1, 2019, and May 31, 2021, there were 4,994 index admissions at EUHM from patients receiving dialysis.
Researchers used interrupted time series and linear models with generalized estimating equations to compare differences in outcomes for the period before (pre-pilot) vs. after implementation of the communication platform (pilot). Using difference-in-difference analyses researchers measured the differences between intervention vs. control facilities. Additionally, sensitivity analyses included a third, pre-pilot/COVID-19 period from March 1, 2020, to Oct. 31, 2020.
Among the 4,994 index admissions recorded, intervention facilities accounted for 1,046. There was no significant difference identified in readmissions during the pilot or pre-pilot periods for intervention facility admissions. Similarly, the difference-in-difference estimate was not significant.
Analyses revealed admission rates dropped during the COVID-19 period; yet again, the change was not statistically significant.
“In this pilot, the introduction of a web-based provider communications platform, DialysisConnect, was generally not statistically significantly associated with reduced readmissions or improved hospital outcomes. However, the development of new approaches to close gaps in the fragmented U.S. health care system remains critical to improving care coordination and, ultimately, outcomes, for this vulnerable population,” Plantinga and colleagues concluded. “Future multi-site studies examining such solutions in larger, community-based dialysis populations, perhaps in concert with efforts to improve patient activation and with one-on-one transitional coaching, are needed to determine the utility of DialysisConnect and similar care coordination platforms.”
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