Transcript of "Technological Resources & Personnel Costs Required to Implement an Automated Alert System for Primary Care Physicians when Patients Transition from Hospitals to Home FIELD"
Terry Field, Lawrence Garber, Shawn Gagne, Jennifer Tjia, Peggy Preusse, Jennifer Donovan, Abir Kanaan, Jerry GurwitzFunding: AHRQ R18 HS017203 and R18 HS017817
Problems with continuity of care High risk transitions Poor communication between physicians caring for patients in and out of the hospital Existing methods to overcome these problems: ◦ from the hospital side ◦ labor intensive ◦ or based on integrated EMR for out-patient clinics and hospitals
1. Can out-patient medical group EMRs be used to provide information to PCPs when patients are discharged to home?2. What are the technological resources and personnel costs needed to develop an automated system providing information about patient transitions to PCPs?
Medical group practice 330 clinicians Approximately 180,000 patients Epic ambulatory EMR In-house medical informatics team
Automated system to facilitate information flow to PCPs about patients discharged to home from hospital or SNFs Includes information about: • new drugs added during hospital stay • warnings about drug-drug interactions • recommendations for dose changes and lab monitoring • reminders to support staff to schedule an office visit
Admission, discharge, Discharge transfer registrationnotification (ADT) interfaceScheduling EMR integrated Information is linked to Info scheduling system data in the EMR database. Program applies rules to New construct messages and EMR pre-discharge Meds direct their flow. Claims post-discharge LabMonitoring Lab results interface
Primary Care ProviderLocally producedinterface engine Support distributes Staff messages
Linkages to hospitals, SNFs, outside labs Scheduling system integrated within the EMR Real time access to claims for dispensed drugs Locally written interface engine application EMR with a flexible database Internal informatics expertise HIT-experienced physician leader
Linkages to hospitals and labs through ADT and ORU interfaces Information about dispensed drugs through Surescripts Internal message delivery through commercially available interface engine
Feasible Requires strong internal informatics expertise Cooperation from hospitals and SNFs Electronic linkages to external facilities Extensive physician time
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