- Costs of care reduced by $944 from a median-cost hospital encounter—an improvement of more than 7 percent, after adjusting for differences in patient illness severity and case complexity.
- Patients’ average length of hospital stay decreased by 6.2 percent.
- The odds of complications improved by 29 percent.
- The odds of hospital readmissions within 30 days of the patients’ original visits shrank by 14 percent.
Friday, August 24, 2018
Another Study That Shows The myHR Is Not Going To Make The Difference We Need.
This study appeared last week:
Published August 17 2018, 7:33am EDT
A new study finds that clinical decision support alerts embedded into a hospital records system have improved patient health and financial outcomes.
Researchers at Cedars-Sinai Medical Center say the results show the positive effects of leveraging Choosing Wisely recommendations. An article on the study was published this week in the American Journal of Managed Care.
For the study, Cedars-Sinai evaluated the 18 highest-volume Choosing Wisely alerts integrated into its Epic EHR. The observational study of 26,424 inpatient encounters examined the associations between adherence to Choosing Wisely recommendations embedded into CDS alerts and four measures of resource use and quality.
“Encounters in which providers adhered to all alerts had significantly lower total costs, shorter lengths of stay, a lower probability of 30-day readmissions, and a lower probability of complications compared with non-adherent encounters,” according to the study’s authors.
When it comes to financial outcomes, the authors noted that adherence to Choosing Wisely alerts was associated with savings of $944 from a median encounter cost of $12,940.
“Inpatient alerts selected for study were those deemed the most technically feasible to deploy accurately and with a sufficient number of relevant orders that would trigger an alert, thus providing a sufficient volume of alerted encounters to evaluate,” state the authors. “When initiating a potentially inappropriate order, a provider received real-time notification of deviation from a CW recommendation. That provider then had the option to cancel, change, or justify the order, if he or she agreed with the alert’s recommendation in the context of the individual patient.”
Here is the link:
And here is come commentary.
Published August 17 2018, 5:49pm EDT
Amid healthcare’s complexities, many providers are trying to streamline their core business, delivering quality patient care at sustainable margins. The objective sounds deceptively simple: Serve the organizational mission by reducing services that provide little value to patients—and can occasionally cause harm. But providers have long sought effective strategies for reaching that elusive goal and continue to do so.
A new study shows how technology can help. Pop-up alerts can aid physicians in treating patients so they experience fewer complications and lower costs, leave the hospital sooner and are less likely to be readmitted. Patients realize these benefits when physicians adhere to alerts in EHRs with care instructions based on evidence-based guidelines, according to the study that was a collaboration between Cedars-Sinai and Optum.
Specifically, the study showed that when physicians follow all clinical decision support (CDS) alerts, their care correlated to significantly better outcomes than for physicians who did not follow all alerts:
The American Journal of Managed Care, a peer-reviewed journal, first published the observational study and noted in an editorial, “This study adds to promising evidence that [clinical decision support] assists clinicians in making value-based clinical decisions and reducing the use of care that is not clinically indicated.”
The study examined data from 26,424 inpatient visits at Cedars-Sinai Medical Center from October 2013 to July 2016 in which one or more of the 18 most frequent alerts was triggered.
Here is the link:
So there you have it! A capability that the secondary myHR can never have is the one that will help reduce the low value and wasteful care the Government so hates. So why don’t they follow the evidence and improve the primary and hospital systems and stop building a largely useless database in the sky (cloud)?
Posted by Dr David G More MB PhD at Friday, August 24, 2018