Daily Editors' Notes

IT project aims to reduce hospital readmissions

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As the government strives to limit rehospitalizations, one nursing home and a couple of hospitals in New York City are staying ahead of the pack.

Parker Jewish Institute for Health Care and Rehabilitation, along with the Long Island Jewish Medical Center and North Shore University Hospital are the first participants in a pilot project through the Continuum of Care Improvement Through Information New York (CCITI NY). How it works: When a resident or patient moves between the nursing home and a hospital, he or she is accompanied by an electronic patient transfer form, which provides information to initiate an appropriate care plan. A clinical decision support tool, which is part of the system, also detects harmful drug-to-drug and drug-to-allergy interactions.

“What makes this project unique is it's not being done electronically anywhere yet,” Michael N. Rosenblut, president and CEO of Parker, told me. “Many times, you'll receive an approved transfer, but the paper doesn't make it with the ambulance and that's a quality-of-care issue.”

Receiving the information electronically is “a huge plus for the patient and the receiving organization,” he said.

One of the valuable aspects of the system, which uses the Internet to send the transfer forms, is that it is separate from any electronic medical record, stakeholders said. This came in handy Nov. 8, the day the system began. A medical employee at Long Island Jewish received the clinical information for a Parker resident even though the hospital's internal record-keeping system was down at the time.

“The general problem with electronic medical records is they don't translate with each other, whereas this is a much simpler [system],” commented Conn Foley, senior vice president for medical services at Parker.

Noted Scott C. Amrhein, president of the Continuing Care Leadership Coalition: "It brings some of the benefits of an EMR to patients between settings, even when one of the providers doesn't have a full medical records [system]."

Cutting rehospitalizations

Ultimately, the goal of the program is to limit avoidable admissions to hospitals and help to mitigate problematic drug interactions during care transfers, decision makers involved in the program said.

“We believe it has the potential to reduce the rate of rehospitalizations because it will enable the nursing homes to have more information for care planning,” Amrhein said.

He and others were keen on emphasizing the benefits of the support tool built into the system to alert clinicians about potentially harmful drug interactions. Such a tool is helpful because the typical nursing home resident takes a handful of medications a day.

“We believe this project, besides helping us looking at our hospitalization rate, from a patient safety perspective, this is just a tremendous step in the right direction,” Rosenblut said.

HIT grant

CCITI NY received one of 19 health information technology grants under the program HEAL NY (Health Care Efficiency and Affordability Law of New York State) Phase 5.

“This was the only project that focuses on the post-acute community and improving the care transitions process,” Amrhein said.

The program encompasses 45 nursing homes. Every stakeholder had to pay matching funds of $8,000, Rosenblut said. Piloting the project will be four pairs of hospitals and nursing homes. Parker and its hospital partners were the first.

As nursing homes and hospitals across the country tackle electronic medical records, improved care transitions and reductions in avoidable trips to the hospital, the project seems to be happening at just the right time.
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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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