OBJECTIVES: Emergency departments (EDs) commonly analyze cases of patients returning within 72 hours of initial ED discharge as potential opportunities for quality improvement. In this study, we tested the use of a health information exchange (HIE) to improve identification of 72-hour return visits compared to individual hospitals' site-specific data. METHODS: We collected deidentified patient data over a 5-year study period from Healthix, an HIE in the New York metropolitan area. We measured site-specific 72-hour ED returns and compared these data to those obtained from a regional 31-site HIE (Healthix) and to those from a smaller, antecedent 11-site HIE. Although only ED visits were counted as index visits, either ED or inpatient revisits within 72 hours of the index visit were considered as early returns. RESULTS: A total of 12,669,657 patient encounters were analyzed across the 31 HIE EDs, including 6,352,829 encounters from the antecedent 11-site HIE. Site-specific 72-hour return visit rates ranged from 1.1% to 15.2% (median = 5.8%) among the individual 31 sites. When the larger HIE was used to identify return visits to any site, individual EDs had a 72-hour return frequency of 1.8% to 15.5% (median = 6.8%). HIE increased the identification ability of 72-hour ED return analyses by a mean of 11.16% (95% confidence interval = 11.10% to 11.22%) compared with site-specific (no HIE) analyses. CONCLUSION: This analysis demonstrates incremental improvements in our ability to identify early ED returns using increasing levels of HIE data aggregation. Although intuitive, this has not been previously described using HIE. ED quality measurement and patient safety efforts may be aided by using HIE in 72-hour return analyses.
OBJECTIVES: Emergency departments (EDs) commonly analyze cases of patients returning within 72 hours of initial ED discharge as potential opportunities for quality improvement. In this study, we tested the use of a health information exchange (HIE) to improve identification of 72-hour return visits compared to individual hospitals' site-specific data. METHODS: We collected deidentified patient data over a 5-year study period from Healthix, an HIE in the New York metropolitan area. We measured site-specific 72-hour ED returns and compared these data to those obtained from a regional 31-site HIE (Healthix) and to those from a smaller, antecedent 11-site HIE. Although only ED visits were counted as index visits, either ED or inpatient revisits within 72 hours of the index visit were considered as early returns. RESULTS: A total of 12,669,657 patient encounters were analyzed across the 31 HIE EDs, including 6,352,829 encounters from the antecedent 11-site HIE. Site-specific 72-hour return visit rates ranged from 1.1% to 15.2% (median = 5.8%) among the individual 31 sites. When the larger HIE was used to identify return visits to any site, individual EDs had a 72-hour return frequency of 1.8% to 15.5% (median = 6.8%). HIE increased the identification ability of 72-hour ED return analyses by a mean of 11.16% (95% confidence interval = 11.10% to 11.22%) compared with site-specific (no HIE) analyses. CONCLUSION: This analysis demonstrates incremental improvements in our ability to identify early ED returns using increasing levels of HIE data aggregation. Although intuitive, this has not been previously described using HIE. ED quality measurement and patient safety efforts may be aided by using HIE in 72-hour return analyses.
Authors: Amber K Sabbatini; K John McConnell; Canada Parrish; Bianca K Frogner; Ashok Reddy; Douglas F Zatzick; William Kreuter; Anirban Basu Journal: Health Serv Res Date: 2022-03-13 Impact factor: 3.734
Authors: Anwar E Ahmed; Bashayr I ALMuqbil; Manair N Alrajhi; Hend R Almazroa; Doaa A AlBuraikan; Monirah A Albaijan; Maliha Nasim; Majid A Alsalamah; Donna K McClish; Hamdan Al-Jahdali Journal: BMC Pediatr Date: 2018-06-26 Impact factor: 2.125
Authors: Heidi Knowles; Charles Huggins; Richard D Robinson; Rosalia Mbugua; Jessica Laureano-Phillips; Shrunjal M Trivedi; Jessica Kirby; Nestor R Zenarosa; Hao Wang Journal: J Clin Med Res Date: 2019-02-13
Authors: Anwar E Ahmed; Doaa A AlBuraikan; Hend R Almazroa; Manair N Alrajhi; Bashayr I ALMuqbil; Monirah A Albaijan; Majid A Alsalamah; Hamdan Al-Jahdali Journal: Ther Clin Risk Manag Date: 2018-08-14 Impact factor: 2.423