This appeared last week.
In search of a better discharge summary
Posted on Jun 18, 2015
By Bernie Monegain, Editor-at-Large
New research under way at University at Buffalo School of Nursing, could lead to automating hospital discharge communication and reducing readmissions. Automating, the discharge process, UB officials say, could add critical data and reduce the time it takes the information to reach community health care providers from weeks to hours.
The preliminary study, led by Sharon Hewner, assistant professor in the School of Nursing, could speed delivery of the hospital discharge summary to less than 24 hours and potentially reduce the number of patients readmitted to hospitals.
The research, "Exploring Barriers to Care Continuity during Transitions: A Mixed-methods Study to Identify Health Information Exchange Opportunities," is funded by a $35,000 UB Innovative Micro-Programs Accelerating Collaboration in Themes, or IMPACT, grant.
"It takes too long to get the information to primary care," says Hewner, in a news release. "If the summary comes in three weeks after the person has been discharged from a hospital, the chances are pretty good that they've already been back, either to the emergency room or for hospitalization."
Although hospitals have been using electronic health records for nearly 10 years, most software is geared toward processing billing. At many hospitals, the discharge summary still relies on U.S. Postal Service for delivery, largely because it is seen as the final step in medical care and has been regarded as not requiring quick processing.
Researchers will use observational data collected at Kaleida Health's hospitals on clinician workflows and documentation around care transitions between the hospital and community.
To create a discharge summary, hospital physicians dictate a report that includes a patient's diagnosis and medical treatment that is later transcribed and mailed to the patient's primary physician.
Today, summaries often omit information from nurses, social workers or therapists that can make a difference in a person's ability to manage his or her own care. The records typically take 10-14 days to reach primary care providers, long after the 48-hour window for follow-up of high-risk cases has passed, says Hewner.
Common problems include duplication of medications already in the home and confusion about where hospitals should send the summary, she adds.
"There's always a clock running on getting someone out fast enough that has a lot to do with some of the financial mechanisms that hospitals get reimbursed under," says Hewner, in a press statement.
"There's always a clock running on getting someone out fast enough that has a lot to do with some of the financial mechanisms that hospitals get reimbursed under," says Hewner, in a press statement.
More is found here:
The full press release is found here:
I found these two paragraphs from the release very sensible:
“Mistakes that could be minimized with an automated discharge summary that treats a patient’s release from a hospital as the next step in the patient’s care, rather than the final step, she says.
To ensure the electronic summary is accepted by all hospitals and doctor’s offices, Hewner will model the summary after the continuity of care document — a medical record created by the Office of the National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services — that all health record software programs are required to be able to read. To transfer the electronic document, a hospital physician would only need to modify and approve the record’s existing data.”
I suspect that if we worked to improve these processes and the associated information flows rather than the money being spent on the PCEHR we would see a more measurable improvement in the health and care of the whole community!
David.
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