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Study shows EHRs' role in cutting readmissions of high-risk heart failure patients

By Steven Ross Johnson

The findings of a new study published this week in BMJ Quality & Safety show the first evidence that electronic health records can play a role in reducing hospital readmissions of high-risk heart failure patients.

The study evaluated more than 1,700 adult inpatients diagnosed with heart failure, myocardial infarction and pneumonia over a two-year period at Parkland Memorial Hospital in Dallas. With the use of software developed to assess the patients on a daily basis at highest risk, researchers were able to reduce the readmission rate of those studied by 26%.

The results could have large implications for the way care is managed for heart-failure patients. They suggest that using an electronic records program that can provide real-time information about a patient can better determine how hospital's resources should be allocated to optimize patient care.

"This is one of the first prospective studies to demonstrate how detailed data in EMRs can be used in real-time to automatically identify and target patients at the highest risk of readmission early in their initial hospitalization when there is a lot that can be done to improve and coordinate their care, so they will do well when they leave the hospital," said Dr. Ethan Halm, senior author on the paper and a professor at UT Southwestern.

Dr. Anand Shah, clinical informatics physician scientist with Parkland Center for Clinical Innovation, said the success of the project has prompted the use of the software at another hospital to see if similar results can be obtained.

"This project was able to achieve the 'holy grail' of readmission reduction strategies,” Halm said. “It reduced the population-based rate of readmission and saved the hospital thousands by redeploying limited, existing resources to the 25% of the patients at highest risk. It was so successful that what started as a research project is now part of the way the hospital does business.”

The study was conducted by investigators from the PCCI, based in Dallas, the University of Texas Southwestern Medical Center in Dallas and the Mayo Clinic, and was funded by grants from the University of Texas System Patient Safety Grant Award Program and the Commonwealth Fund.

Follow Steven Ross Johnson on Twitter: @MHSjohnson


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