Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge

Abstract Outpatient follow-up after hospital discharge improves continuity of care and reduces readmissions, but rates of follow-up remain low. It is not known whether electronic medical record (EMR)-based tools improve follow-up. The aim of this study was to determine if an EMR-based order to secur...

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Autores principales:	Kartik S. Telukuntla, Chetan P. Huded, Mingyuan Shao, Tim Sobol, Mouin Abdallah, Kathleen Kravitz, Michael Hulseman, Benico Barzilai, Randall C. Starling, Lars G. Svensson, Steven E. Nissen, Umesh N. Khot
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/ed47b3d1cc1e4028b70f1c8f54bfbf28
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spelling	oai:doaj.org-article:ed47b3d1cc1e4028b70f1c8f54bfbf282021-12-02T15:38:24ZImpact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge10.1038/s41746-021-00443-22398-6352https://doaj.org/article/ed47b3d1cc1e4028b70f1c8f54bfbf282021-05-01T00:00:00Zhttps://doi.org/10.1038/s41746-021-00443-2https://doaj.org/toc/2398-6352Abstract Outpatient follow-up after hospital discharge improves continuity of care and reduces readmissions, but rates of follow-up remain low. It is not known whether electronic medical record (EMR)-based tools improve follow-up. The aim of this study was to determine if an EMR-based order to secure cardiology follow-up appointments at hospital discharge would improve follow-up rates and hospital readmission rates. A pre-post interventional study was conducted and evaluated 39,209 cardiovascular medicine discharges within an academic center between 2012 and 2017. Follow-up rates and readmission rates were compared during 2 years prior to EMR-order implementation (pre-order era 2012–2013, n = 12,852) and 4 years after implementation (EMR-order era 2014–2017, n = 26,357). The primary endpoint was 90-day cardiovascular follow-up rates within our health system. In the overall cohort, the mean age of patients was 69.3 years [SD 14.7] and 60.7% (n = 23,827) were male. In the pre-order era, 90-day follow-up was 56.7 ± 0.4% (7286 of 12,852) and increased to 67.9 ± 0.3% (17,888 of 26,357, P < 0.001) in the EMR-order era. The use of the EMR follow-up order was independently associated with increased outpatient follow-up within 90 days after adjusting for patient demographics and payor status (OR 3.28, 95% CI 3.10–3.47, P < 0.001). The 30-day readmission rate in the pre-order era was 12.8% (1642 of 12,852) compared with 13.7% (3601 of 26,357, P = 0.016) in the EMR-order era. An EMR-based appointment order for follow-up appointment scheduling was associated with increased cardiovascular medicine follow-up, but was not associated with an observed reduction in 30-day readmission rates.Kartik S. TelukuntlaChetan P. HudedMingyuan ShaoTim SobolMouin AbdallahKathleen KravitzMichael HulsemanBenico BarzilaiRandall C. StarlingLars G. SvenssonSteven E. NissenUmesh N. KhotNature PortfolioarticleComputer applications to medicine. Medical informaticsR858-859.7ENnpj Digital Medicine, Vol 4, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Computer applications to medicine. Medical informatics R858-859.7 Kartik S. Telukuntla Chetan P. Huded Mingyuan Shao Tim Sobol Mouin Abdallah Kathleen Kravitz Michael Hulseman Benico Barzilai Randall C. Starling Lars G. Svensson Steven E. Nissen Umesh N. Khot Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge
description	Abstract Outpatient follow-up after hospital discharge improves continuity of care and reduces readmissions, but rates of follow-up remain low. It is not known whether electronic medical record (EMR)-based tools improve follow-up. The aim of this study was to determine if an EMR-based order to secure cardiology follow-up appointments at hospital discharge would improve follow-up rates and hospital readmission rates. A pre-post interventional study was conducted and evaluated 39,209 cardiovascular medicine discharges within an academic center between 2012 and 2017. Follow-up rates and readmission rates were compared during 2 years prior to EMR-order implementation (pre-order era 2012–2013, n = 12,852) and 4 years after implementation (EMR-order era 2014–2017, n = 26,357). The primary endpoint was 90-day cardiovascular follow-up rates within our health system. In the overall cohort, the mean age of patients was 69.3 years [SD 14.7] and 60.7% (n = 23,827) were male. In the pre-order era, 90-day follow-up was 56.7 ± 0.4% (7286 of 12,852) and increased to 67.9 ± 0.3% (17,888 of 26,357, P < 0.001) in the EMR-order era. The use of the EMR follow-up order was independently associated with increased outpatient follow-up within 90 days after adjusting for patient demographics and payor status (OR 3.28, 95% CI 3.10–3.47, P < 0.001). The 30-day readmission rate in the pre-order era was 12.8% (1642 of 12,852) compared with 13.7% (3601 of 26,357, P = 0.016) in the EMR-order era. An EMR-based appointment order for follow-up appointment scheduling was associated with increased cardiovascular medicine follow-up, but was not associated with an observed reduction in 30-day readmission rates.
format	article
author	Kartik S. Telukuntla Chetan P. Huded Mingyuan Shao Tim Sobol Mouin Abdallah Kathleen Kravitz Michael Hulseman Benico Barzilai Randall C. Starling Lars G. Svensson Steven E. Nissen Umesh N. Khot
author_facet	Kartik S. Telukuntla Chetan P. Huded Mingyuan Shao Tim Sobol Mouin Abdallah Kathleen Kravitz Michael Hulseman Benico Barzilai Randall C. Starling Lars G. Svensson Steven E. Nissen Umesh N. Khot
author_sort	Kartik S. Telukuntla
title	Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge
title_short	Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge
title_full	Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge
title_fullStr	Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge
title_full_unstemmed	Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge
title_sort	impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ed47b3d1cc1e4028b70f1c8f54bfbf28
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Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge

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