Society of Hospital Medicine Health Information Technology committee members recently asked high-performing hospitals what EHR tool or intervention had the most effect on keeping readmissions low.
The interviews led to the following five recommendations for using EHRs to reduce all-cause readmissions.
1. Use EHR data to identify patients at the highest risk for readmission, and allocate resources appropriately. Augusta Health in Fishersville, Va., uses data from the EHR on a patient's length of stay, acuity, comorbidities and emergency department visits to determine risk for readmission, and then shares this information with case managers, who then decide to which patients the care team should direct the most attention.
2. Use EHRs to communicate with primary care physicians. Lahey Health System in Burlington, Mass., used secure email in conjunction with data in "handoff reports," which included patient information and clinical summaries, to improve communication with unaffiliated physicians, helping to reduce the health system's 30-day readmission rate to less than 15 percent.
3. Use EHRs to improve medication reconciliation. At Aurora Healthcare in Milwaukee, pharmacy technicians enter home medications into the EHR directly, allowing physicians to perform more accurate medication reconciliations and keeps medication lists consistent between inpatient and outpatient settings. The 30-day readmission rate at Aurora Healthcare is now less than 16 percent, thanks in part to this new medication reconciliation process.
4. Use EHRs to support multidisciplinary rounds. At Northwestern Lake Forest (Ill.) Hospital, all members of a patient's care team attend bedside rounds. The EHR supports these rounds through customized templates that display the most relevant information for these types of rounds.
5. Use EHRs to improve patient education. Northwestern Lake Forest Hospital also uses its EHR to allow multiple providers to contribute information to a patient's discharge paperwork and provides patients with EHR-integrated, customized educational materials. This intervention, the rounding process described above and other interventions have helped reduce the hospital's 30-day readmission rate to around 11 percent.
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