Coordinating care transitions from the acute care hospital to post-acute care settings is a complicated process. These problems persist in spite of the fact that such transitions are common. Reviews have estimated that 11% of hospitalized Medicare beneficiaries have a transition to an in-patient rehabilitation facility and 28% have a discharge to a home health agency1. The lack of common IT infrastructure between these organizations and the acute care hospital contributes to problems in communication.
Medication errors are one of the most common errors related to lack of coordination between acute and post-acute care settings. It has been estimated that 60% of medication errors occur during times of care transition2. Such errors can contribute to significant morbidity and costs for the entire health care system. Medication errors may also result in readmission to the acute care hospital. Many of the readmissions to acute care hospitals for Medicare and Medicaid beneficiaries have been estimated to be avoidable – up to 45% in one study3. Clearly better communication is one place to focus on reducing both errors and readmissions.
In the acute care hospital and often across the care continuum in integrated delivery networks or accountable care organizations the electronic medical record plays a key role in care coordination and communication. Post-acute and long term care facilities are estimated to have a lower adoption rate for such IT technology. This is probably related to the cost for such technology and the incentives which have recently been put in place to support the adoption of IT technology in other settings.
How can the communication required for care coordination be better supported? One approach is using cloud-based solutions designed to improve patient engagement before, during, and after treatment. This engagement enables organizations to glean insight early on about possible complications, which can lead to readmissions. Such internet solutions are generally less costly than stand-alone solutions and can often be implemented with much less IT staff support. VitalHealth Software has a solution that bridges the communication gap and improves care quality. For more information, please visit www.vitalhealthsoftware.com.
Dr. Lester Wold
CMO VitalHealth Software
1: Examining Relationships in an Integrated Hospital System. March 2008 - Final Report.http://aspe.hhs.gov/health/reports/08/examine/report.html
2: National Transitions of Care Coalition. Improving Transitions of Care: The Vision of the National Transitions of Care Coalition. May 2008. Available at: http://www.ntocc.org/Portals/0/PolicyPaper.pdf.
3: Walsh, E., Freiman, M., Haber, S., Bragg, A., Ouslander, J., & Wiener, J. (2010). Cost Drivers for Dually Eligible Beneficiaries: Potentially Avoidable Hospitalizations from Nursing Facility, Skilled Nursing Facility, and Home and Community Based Services Waiver Programs. Washington, DC: CMS.