• Jerry H Gurwitz, Terry S Field, Jessica Ogarek, Jennifer Tjia, Sarah L Cutrona, Leslie R Harrold, Shawn J Gagne, Peggy Preusse, Jennifer L Donovan, Abir O Kanaan, George Reed, and Lawrence Garber.
• Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group and Fallon Community Health Plan, Worcester, Massachusetts.
• J Am Geriatr Soc. 2014 May 1; 62 (5): 865-71.

ObjectivesTo assess the effect of an electronic health record-based transitional care intervention involving automated alerts to primary care providers and staff when older adults were discharged from the hospital.DesignRandomized controlled trial.SettingLarge multispecialty group practice.ParticipantsIndividuals aged 65 and older discharged from hospital to home.InterventionIn addition to notifying primary care providers about the individual's recent discharge, the system provided information about new drugs added during the inpatient stay, warnings about drug-drug interactions, recommendations for dose changes and laboratory monitoring of high-risk medications, and alerts to the primary care provider's support staff to schedule a posthospitalization office visit.MeasurementsAn outpatient office visit with a primary care provider after discharge and rehospitalization within 30 days after discharge.ResultsOf the 1,870 discharges in the intervention group, 27.7% had an office visit with a primary care provider within 7 days of discharge. Of the 1,791 discharges in the control group, 28.3% had an office visit with a primary care provider within 7 days of discharge. In the intervention group, 18.8% experienced a rehospitalization within the 30-day period after discharge, compared with 19.9% in the control group. The hazard ratio for an office visit with a primary care physician did not significantly differ between the intervention and control groups. The hazard ratio for rehospitalization in the 30-day period after hospital discharge in the intervention versus the control group was 0.94 (95% confidence interval = 0.81-1.1).ConclusionThis electronic health record-based intervention did not have a significant effect on the timeliness of office visits to primary care providers after hospitalization or risk of rehospitalization.© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

25 keywords...

hide…