Discussion A considerable number of patients do not identify a PCP when admitted for inpatient care,...
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0 3000 6000 9000 12000 15000 Discussion • A considerable number of patients do not identify a PCP when admitted for inpatient care, and not all follow-up appointments take place with a PCP. • The best predictor of who patient would meet with in the six months after the inpatient encounter was providers who had dictated a note for the patient in the previous six months. • Dictated note(s): 67% • Previous Appointment: 64% • PCP as identified by patient: 37% • Even among the subpopulation of patients who identified a PCP, less than half of follow- up appointments were with the PCP identified. Who should receive documentation on Inpatient Encounters? Jacob S. Tripp BS, Stanley M. Huff MD University of Utah, Salt Lake City, UT; Intermountain Healthcare, Salt Lake City, UT Acknowledgements • National Library of Medicine Training Grant • Intermountain Healthcare Contact Information Jacob S. Tripp University of Utah, Dept. of Biomedical Informatics [email protected] Materials and Methods • Intermountain Healthcare EMR spans in- and out-patient care. • For two hospitals, in the first half of 2006, there were 14,469 inpatient encounters. • 72% of these encounters had a PCP identified by the patient. • Three heuristics were compared for determining who should be notified about inpatient care. • PCP as identified by patient. • Providers who had at least one outpatient appointment with the patient in the six months preceding the inpatient encounter • Providers who dictated at least one note about the patient in the six months preceding the inpatient encounter Introduction In today’s healthcare environment, patients are often treated by numerous specialists, and Primary Care Providers (PCPs) must attempt to coordinate the care provided by all of these specialists. Often critical details of inpatient care episodes are not successfully communicated to outpatient providers charged with follow-up care. Vital to the successful communication of these details is the correct identification of who should be receiving this communication. This poster compares the ability of three different methods to predict what provider patients will meet with following an episode of inpatient care. Validation of Primary Care Provider Data in Hospital Admission Records Inpatient Encounters for First 6 months of 2006 Conclusions • PCP data provided by patients in admission records identify less than half of providers who will treat the patient in the near future. • Other heuristics which include data from outpatient care episodes can be very helpful in predicting which providers should be notified. Discharge Documentation Primary Care Provider Named in Admission Data Providers who Dictated Notes on Patient Providers who had Appointments with Patient ? All Encounter s Encounters w/ PCP Identified Encounters w/ Follow-up Appt. in next six months Appt. w/ PCP Appt. w/ PCP Appt. w/ PCP Appt. w/ provider that dictated a note in prev. six months Appt. w/ provider that patient had appt. with in prev. six months Looking only at those encounters where a PCP was identified during the inpatient stay, 69% of these encounters had a subsequent follow-up appointment. Only 48% of these were with the PCP listed. The other two bars compare follow-up appointments with providers who the patient had seen prior to the inpatient encounter and with those who dictated notes for the patient in the previous six months. 0 3000 6000 9000 12000 15000 Follow-up Appt. in next six months Appt. w/ PCP Appt. w/ Previous Provider Appt. w/ Dictating Provider PCP Identified for Encounter All Encounter s 64% of all inpatient encounters in the first six months of 2006 had a subsequent outpatient appointment in the next six months. 78% of encounters with a subsequent outpatient appointment had a PCP identified, but only 37% of these visits were with that provider. 64% of follow-up visits were with a provider who the patient had seen in the previous six months and 67% of follow-ups were with a provider who had dictated a note for the patient in the previous six months.
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Transcript of Discussion A considerable number of patients do not identify a PCP when admitted for inpatient care,...
0 3000 6000 9000 12000 15000
Discussion• A considerable number of patients do not identify a PCP when admitted for inpatient care, and not all follow-up appointments take place with a PCP.
• The best predictor of who patient would meet with in the six months after the inpatient encounter was providers who had dictated a note for the patient in the previous six months.
• Dictated note(s): 67%• Previous Appointment: 64%• PCP as identified by patient: 37%
• Even among the subpopulation of patients who identified a PCP, less than half of follow-up appointments were with the PCP identified.
Who should receive documentation on Inpatient Encounters?
Jacob S. Tripp BS, Stanley M. Huff MDUniversity of Utah, Salt Lake City, UT; Intermountain Healthcare, Salt Lake City, UT
Acknowledgements• National Library of Medicine Training Grant
• Intermountain Healthcare
Contact InformationJacob S. TrippUniversity of Utah, Dept. of Biomedical [email protected]
Materials and Methods• Intermountain Healthcare EMR spans in- and out-patient care.
• For two hospitals, in the first half of 2006, there were 14,469 inpatient encounters.
• 72% of these encounters had a PCP identified by the patient.
• Three heuristics were compared for determining who should be notified about inpatient care.
• PCP as identified by patient.
• Providers who had at least one outpatient appointment with the patient in the six months preceding the inpatient encounter
• Providers who dictated at least one note about the patient in the six months preceding the inpatient encounter
• All three methods compared against patient schedule for six months following discharge from inpatient encounter.
IntroductionIn today’s healthcare environment, patients are often treated by numerous specialists, and Primary Care Providers (PCPs) must attempt to coordinate the care provided by all of these specialists. Often critical details of inpatient care episodes are not successfully communicated to outpatient providers charged with follow-up care.
Vital to the successful communication of these details is the correct identification of who should be receiving this communication. This poster compares the ability of three different methods to predict what provider patients will meet with following an episode of inpatient care.
Validation of Primary Care Provider Data in Hospital Admission Records
Inpatient Encounters for First 6 months of 2006
Conclusions• PCP data provided by patients in admission records identify less than half of providers who will treat the patient in the near future.
• Other heuristics which include data from outpatient care episodes can be very helpful in predicting which providers should be notified.
DischargeDocumentation
Primary Care ProviderNamed in
Admission Data
Providers who Dictated Notes
on Patient
Providers who had Appointments with
Patient
?
All Encounters
Encounters w/ PCP Identified
Encounters w/ Follow-up Appt. in next six monthsAppt. w/ PCP
Appt. w/ PCP
Appt. w/ PCPAppt. w/ provider that dictated a note in prev. six months
Appt. w/ provider that patient had appt. with in prev. six months
Looking only at those encounters where a PCP was identified during
the inpatient stay, 69% of these encounters had a subsequent
follow-up appointment. Only 48% of these were with the PCP listed.
The other two bars compare follow-up appointments with providers
who the patient had seen prior to the inpatient encounter and with those who dictated notes for the
patient in the previous six months.
0 3000 6000 9000 12000 15000
Follow-up Appt. in next six months
Appt. w/ PCP
Appt. w/ Previous Provider
Appt. w/ Dictating Provider
PCP Identified for Encounter
All Encounters
64% of all inpatient encounters in the first six months of 2006 had a
subsequent outpatient appointment in the next six months. 78% of encounters with a subsequent
outpatient appointment had a PCP identified, but only 37% of these
visits were with that provider. 64% of follow-up visits were with a
provider who the patient had seen in the previous six months and 67%
of follow-ups were with a provider who had dictated a note for the
patient in the previous six months.
