Dr. Conn Foley, SVP Medical Services, Parker Jewish Geriatric Institute for Health Care and Rehabilitation, Harrison Fox, Executive Director, Continuum of Care Improvement through Information (CCITI) New York.
Impacts and Benefits
- Interoperability with other care providers either directly or through a Health Information Exchange (HIE)
- Clinical Decision Support Systems (CDSS) including those aimed at reducing inappropriate hospital admission and acute care transfers
Parker Jewish Institute for Health Care and Rehabilitation is composed of a skilled nursing facility, long-term care rehabilitation, home health and home care, adult daycare, and rehabilitation. Continuum of Care Improvement through Information New York is a not-for-profit engaged in health information exchange.
Since its inception in 1907, Parker Jewish Institute has evolved into a nationally recognized 527-bed, non-profit center for the health care and rehabilitation of adults, and a comprehensive network of community health care programs for adults. Parker Jewish Institute provides on-site dialysis and medical transportation to its residents and patients, and to the region’s communities. It is also a leading academic campus for the training of health care professionals, an important research center for studies related to aging, and a partner in a New York State-authorized managed long-term care plan, AgeWell New York.
CCITI NY was established to improve the quality, patient safety, cost, and satisfaction aspects of transferring patients between acute, post-acute, and ambulatory care organizations in the greater New York metropolitan region. The CCITI NY Care Coordination System (CCS) will combine the strength of a standardized electronic transfer form process with an automated clinical decision support tool.
Improve the quality and effectiveness of care provided to patients transitioning between acute and post-acute settings by providing key information to care providers in advance of patient arrival.
In 2010, Parker Jewish Institute first went live with the CCITI NY CCS, allowing clinicians to be digitally connected with their counterparts at nearby Long Island Jewish Medical Center. Long Island Jewish Medical Center’s staff and clinicians employ SigmaCare, an EHR system for long-term and post-acute care (LTPAC) facilities that automates the complete clinical workflow. The clinicians utilize the Healthix Regional Health Information Exchange (RHIO) to gain access to patient data generated by their hospital and community provider partners, and are enabled to launch a transfer form with pertinent data from the RHIO. The clinicians at the facility were trained on, and adopted, an electronic workflow for sending and receiving important patient data when transfers take place. They also benefit from a sophisticated drug-drug and drug-allergy clinical decision support system (CDSS) tool that reduces the potential for medication errors.
Reduced Medication Errors: During an initial pilot study of the impact of CCITI NY, a 10% reduction in the rate of medication errors, post intervention, was found. The study examined medication errors over a 6-month post-implementation period in 2011, for approximately 500 patients. Additional studies are planned to reexamine these outcomes.
Reduced Avoidable Hospital Admissions: Between January 2011 and July 2011, the re-hospitalization rate associated with the nursing home’s partner hospital, using the CCS system, was 20.2 percent, lower than the total re-hospitalization rate of 22.9 percent for non-participating sites.
Lessons Learned/Advice to Share with Others Pertinent information provided to clinicians during resident transfer can improve quality of care. The quality and safety components of managing and coordinating care for older and disabled patients with complex medical conditions, who are being treated with multiple medications, can be improved through automated clinical decision support tools. Improving medication management for this patient population can potentially improve their transition across the continuum of care, and result in reduced readmission to acute care facilities.
© Copyright 2013 LeadingAge Center for Aging Services Technologies (CAST)
July 25, 2013