Better Connections Among Health Information Technology Systems Can Reduce Patient Safety Events

AHRQ Stats: Payments Vary for Public, Private Physician Office Visits

Medicaid payments to physicians for office visits in 2014-15 averaged 62 percent of payments made to physicians by employer-sponsored insurance. (Source: Public and Private Payments For Physician Office Visits, Health Aff. 2017 Dec;36(12):2160-2164.)

Today's Headlines:

• Better Connections Among Health Information Technology Systems Can Reduce Patient Safety Events.
• AHRQ Grantee Tejal Gandhi, M.D., Boosts Clinician Use of Health Information Technology.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ Releases Updated Data on Hospital Inpatient Stays, Readmissions.
• Institute for Healthcare Improvement Provides Blueprint for Improving Referral Process.
• Featured Case Study: California Liability Insurer Discounts Premiums for Companies That Adopt AHRQ-Developed Safety Program.
• AHRQ in the Professional Literature.

Better Connections Among Health Information Technology Systems Can Reduce Patient Safety Events

Providers can reduce patient safety events by improving connections among their electronic health records (EHRs) and their other health information technology (IT) systems, according to an AHRQ-funded study in Applied Clinical Informatics. A review of 1.7 million safety event reports from multiple health care systems in the mid-Atlantic region between 2009 and 2016 showed 209 events related to interoperability. Most involved poor communication from pharmacy, laboratory and radiology systems to the EHR, with more than 60 percent of events occurring within the same provider organization. While only 2 percent of events caused actual patient harm, more than 50 percent reached the patient and could have caused harm. Researchers suggested that providers trying to improve their health IT interoperability should look first at pharmacy systems and medication-related events.

AHRQ Grantee Tejal Gandhi, M.D., Boosts Clinician Use of Health Information Technology

AHRQ-funded research by Tejal Gandhi, M.D., chief clinical and safety officer of the Institute for Healthcare Improvement, has helped clinicians adopt health information technology and improve patient safety. Dr. Gandhi's work has shown that medication errors and adverse drug events could be lowered in hospital and outpatient settings by using a wide range of technologies, including electronic medication administration systems, barcode technology, computerized physician order entry and clinical decision support systems. Access her profile and those of other AHRQ grantees who have made major advances in health services research.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• The effects of crew resource management on teamwork and safety climate at Veterans Health Administration facilities.
• Are parents who feel the need to watch over their children's care better patient safety partners?
• Effect of health information exchange on recognition of medication discrepancies is interrupted when data charges are introduced: results of a cluster-randomized controlled trial.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

AHRQ Releases Updated Data on Hospital Inpatient Stays, Readmissions

Now available for purchase are AHRQ’s 2015 National Inpatient Sample (NIS) and the 2015 Nationwide Readmissions Database (NRD), premier databases that enable analysis of all-payer hospital inpatient stays and readmissions. Part of the agency’s Healthcare Cost and Utilization Project (HCUP), the databases support efforts by researchers and policymakers to quantify and track national trends broken down by patient characteristics and use of hospital resources. To ensure researchers’ appropriate use of the NIS, AHRQ released a checklist of major methodological considerations. The HCUP family of health care databases and related software tools and products is made possible by a federal-state-industry partnership sponsored by AHRQ. The updated NIS and NRD databases are available from AHRQ’s HCUP Central Distributor.

Institute for Healthcare Improvement Provides Blueprint for Improving Referral Process

New guidance from the Institute for Healthcare Improvement describes safe practices for ensuring effective communication among primary care practitioners, specialists and patients. Breakdowns in the referral process are a significant patient safety issue, as they can lead to delays in diagnosis and treatment. Closing the Loop: A Guide to Safer Ambulatory Referrals in the EHR Era outlines a “closed-loop” referral process, a nine-step workflow in which all relevant patient information is communicated to the correct person through the appropriate channels and in a timely manner.  The guidance includes tools and strategies for implementing each step of the process as well as solutions for common pitfalls. Also included are general recommendations for stakeholders including clinicians, practice leaders and electronic health record vendors.

Featured Case Study: California Liability Insurer Discounts Premiums for Companies That Adopt AHRQ-Developed Safety Program

BETA Healthcare Group, a large medical liability insurer in California, offers up to a 10 percent discount on annual insurance premiums to customers that adopt the company’s BETA HEART patient safety program, which is based on AHRQ’s Communication and Optimal Resolution (CANDOR) toolkit. Access the Impact Case Study.

AHRQ in the Professional Literature

Changes in rates of ventilator-associated pneumonia-reply. Metersky ML, Klompas M, Eldridge N. JAMA 2017 Apr 18;317(15):1581-82. Access the abstract on PubMed®.

Screening for abnormal blood glucose and type 2 diabetes mellitus. Ngo-Metzger Q, Owings J. Am Fam Physician 2016 Jun 15;93(12):1025-6. Access the abstract on PubMed®.

Dosing of intravenous tocilizumab in a real-world setting of rheumatoid arthritis: analyses from the Corrona registry. Pappas DA, John A, Curtis JR, et al. Rheumatol Ther 2016 Jun;3(1):103-15. Epub 2016 Feb 8. Access the abstract on PubMed®.

Longitudinal investigation of rehospitalization patterns in spinal cord injury and traumatic brain injury among Medicare beneficiaries. Pretz CR, Graham JE, Middleton A, et al. Arch Phys Med Rehabil 2017 May;98(5):997-1003. Epub 2017 Jan 20. Access the abstract on PubMed®.

Guiding lay navigation in geriatric patients with cancer using a distress assessment tool. Rocque GB, Taylor RA, Acemgil A, et al. J Natl Compr Canc Netw 2016 Apr;14(4):407-14. Access the abstract on PubMed®.

BMT roadmap: a user-centered design health information technology tool to promote patient-centered care in pediatric hematopoietic cell transplantation. Runaas L, Hanauer D, Maher M, et al. Biol Blood Marrow Transplant 2017 May;23(5):813-19. Epub 2017 Jan 27. Access the abstract on PubMed®.

Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records. Ryu E, Chamberlain AM, Pendegraft RS, et al. BMC Psychiatry 2016 Apr 26;16:114. Access the abstract on PubMed®.

Differences in mental workload between traditional and single-incision laparoscopic procedures measured with a secondary task. Scerbo MW, Britt RC, Stefanidis D. Am J Surg 2017 Feb;213(2):244-48. Epub 2016 Oct 8. Access the abstract on PubMed®.