An automated EHR readmission risk flag based on ≥2 prior admissions identified high-risk patients with a C statistic of 0.61, but had no effect on 30-day all-cause or 7-day unplanned readmissions.
Cohort
Yes
Does an automated readmission risk flag integrated into the EHR reduce 30-day all-cause and 7-day unplanned readmissions in adult admitted patients?
An automated EHR readmission risk flag successfully identified high-risk patients but did not reduce 30-day or 7-day readmission rates.
BACKGROUND: Identification of patients at high risk for readmission is a crucial step toward improving care and reducing readmissions. The adoption of electronic health records (EHR) may prove important to strategies designed to risk stratify patients and introduce targeted interventions. OBJECTIVE: To develop and implement an automated prediction model integrated into our health system's EHR that identifies on admission patients at high risk for readmission within 30 days of discharge. DESIGN: Retrospective and prospective cohort. SETTING: Healthcare system consisting of 3 hospitals. PATIENTS: All adult patients admitted from August 2009 to September 2012. INTERVENTIONS: An automated readmission risk flag integrated into the EHR. MEASURES: Thirty-day all-cause and 7-day unplanned healthcare system readmissions. RESULTS: Using retrospective data, a single risk factor, ≥ 2 inpatient admissions in the past 12 months, was found to have the best balance of sensitivity (40%), positive predictive value (31%), and proportion of patients flagged (18%), with a C statistic of 0.62. Sensitivity (39%), positive predictive value (30%), proportion of patients flagged (18%), and C statistic (0.61) during the 12-month period after implementation of the risk flag were similar. There was no evidence for an effect of the intervention on 30-day all-cause and 7-day unplanned readmission rates in the 12-month period after implementation. CONCLUSIONS: An automated prediction model was effectively integrated into an existing EHR and identified patients on admission who were at risk for readmission within 30 days of discharge.
Baillie et al. (Wed,) conducted a cohort in Risk for hospital readmission. Automated readmission risk flag in EHR vs. Retrospective cohort (pre-implementation) was evaluated on Thirty-day all-cause and 7-day unplanned healthcare system readmissions. An automated EHR readmission risk flag based on ≥2 prior admissions identified high-risk patients with a C statistic of 0.61, but had no effect on 30-day all-cause or 7-day unplanned readmissions.
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