Monday, September 16, 2013

Intensive targeting of resources to high risk heart failure patients

---reduced readmissions in this study.

Medpage Today reports the study as showing that EMRs Lower Odds of Heart Failure Readmission. But that's not what the study showed at all. The EMR helped target patients for intervention, but it was not the intervention. The intervention included:

...(1) detailed inpatient clinical assessment, patient education and discharge planning by a HF nurse practitioner, pharmacist, nutritionist and case manager starting early in the hospital course; (2) a follow-up telephone call from a nurse within 48 h of discharge to assess whether the patient had obtained their medication and was aware of their outpatient follow-up appointments; (3) outpatient case management (consisting of individualised care management services based on specific post-discharge needs) for 30 days; (4) a cardiology appointment with a HF specialist within 7 days of discharge and subsequent cardiology follow-up for at least 1 month; and (5) a primary care appointment scheduled according to the urgency of non-cardiac problems.

The same EMR was in place during the control period.

The EMR can be leveraged in many effective ways but there is no evidence to support the popular belief that just having an EMR improves patient outcomes.

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