Viewing medical history through HIE reduces readmissions

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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.

The study tracked whether ED physicians looked at patient medical histories after an information system was installed linking the state-run HMO's seven hospital and various clinics. Data on patients covered by the HMO would be compiled from these various sources, presumably offering a more complete picture. Other patients' data would be limited to that from the facility where they were being treated.

Only 31.2 percent of ED physicians accessed the medical histories at all, according to the study published in BMC Medical Informatics and Decision Making. The study looked at seven-day readmissions and single-day admissions for frequent diagnoses: chest pain, abdominal pain, gastroenteritis, urinary tract infection (UTI) and pneumonia organism.

When the external medical histories were consulted, the likelihood of seven-day readmissions decreased 48 percent overall and by 27.2 percent compared with viewing only the local information. Diagnoses of abdominal pain, UTI and abdominal pain saw the largest drop in readmissions.

Viewing external medical history was associated with a 35 percent reduction in single-day admissions overall and 13 percent reduction compared with viewing the local data. There, diagnoses of gastroenteritis, abdominal pain and chest pain experienced the greatest drop in admissions.

With the Medicare program penalizing hospitals with excessive readmissions, healthcare organizations are searching for every method they can find for improvement. A second recalculation of the formula used to calculate readmission penalties, however, recently provided relief to some hospitals with high readmission rates.

A study from Partners HealthCare Network in Boston found that assessing risk and assigning patients a predictive score as they leave the hospital could prevent them from having to return.

University of Pennsylvania research, meanwhile, urged hospitals not to ignore ED visits after hospitalization. Those trips should be considered a return to acute care, its authors said.

To learn more:
- check out the research (.pdf)

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