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EHRs Help Drive Down Hospital Readmissions

by Margaret Schulte, consultant, HIMSS EHR Value Suite Collection


Hospital readmissions are expensive for both the hospital and the patient, and often reflect opportunity for care improvements. With the implementation of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) adjusted payments to hospitals for readmissions that occur within 30 days of discharge for defined conditions.  Incentives and other quality improvement initiatives have helped to drive down readmission rates in the five years between 2010 and 2015. While the reductions in readmission rates vary by state, overall they fell by 8 percent nationally during this time period. In 2015 alone, approximately 100,000 readmissions were avoided. (Conway and Gronniger, 2016)

Accomplishing these readmissions reductions means that care coordination, patient communication, safety and quality of care have improved. These improvements have been made possible because of information systems that support data capture, accuracy, analysis, sharing and communication.  
Readmission reductions have happened through the efforts of long-term care providers, Beacon communities, home health care givers and others, as well as through the work of hospitals and health systems. For example, the Aloha Nursing Rehab Centre in Kaneohe, Hawaii, succeeded in reducing its readmission rate from 26.6 percent in early 2011 to 9.5 percent by the end of 2012 by using health IT. With the help of its electronic health record (EHR) and the work of its accountable care organization (ACO), Centura Health reported: 

  • A 15.65 percent reduction in readmissions for heart failure.
  • A 18.32 percent reduction in diabetes readmissions in one year.
  • A 16.02 percent reduction in COPD readmissions in one year.

These are examples of only two organizations whose initiatives are keeping patients out of the hospital and reducing costs while improving care. There are many more examples.  Here are a few of them:

  • For Milford Regional Medical Center, the EHR and health information exchange helps to reduce readmissions by automatically sending discharge documentation to outside providers, improving communication and care coordination.
  • With its EHR, the Norman Regional Health System achieved a 40 percent reduction in readmissions at all of the system’s facilities.
  • Regina Health Center in Richfield, Ohio, used its EHR to facilitate an overall drop in the readmission rate from 18 to 9.8 percent.
  • Norfolk, Virginia’s Sentara Healthcare reported that readmission rates at four hospitals were reduced by more than 18 percent.
  • Summa Health System in Akron, Ohio, reported that 36 percent fewer patients were readmitted within a 31-day period.
  • TriHealth, Inc., in Cincinnati, Ohio, used standardized documentation and scoring tools to help reduce the 30-day readmission rates by 16 percent for high-risk patients.
  • Yale-New Haven Hospital reported in 2016 that its EHR supports care redesign, which reduces readmissions and average length of stay.
  • For St. Elizabeth Hospital, in Enumclaw, Wash., the EHR enabled chronic heart failure readmissions to be reduced from 20 percent to 10 percent.

Concurrently, a number of these hospitals and health systems reported that they have successfully reduced the length of stay in their facilities, thereby further reducing costs and improving the quality of patient care. For example,

  • Centura Health reduced overall length of stay from 4.5 days in 2012 to 4.22 days in 2015 with the help of its EHR.
  • Using best practice alerts and alerts imbedded in order sets, TriHealth, Inc., succeeded in reducing ICU length of stay by 1.3 days.

In summary, while these are only a few examples of the thousands that are recounted in the HIMSS Value Suite Collection, the message is clear: the EHR is an essential tool to improved quality of care and reductions in cost, not only for the country but also for providers and patients.

Find out why Dr. Michael Zaroukian, Chair of the HIMSS North America Board of Directors, attends HIMSS17

Reference
Conway, P. & Gronniger, T. (September 13, 2016). New data: 49 states plus DC reduce avoidable hospital readmissions. The CMS Blog. Accessed December 2, 1016.

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