- Email-based care transition systems improve care coordination and follow-up scheduling, resulting in fewer hospital readmissions, a study in the December American Journal of Accountable Care suggests.
- The researchers compared inpatient and outpatient care teams that received secure team-based emails and those that did not and found markedly higher rates of 7-day postdischarge primary care visits — 53% versus 38%.
- An analysis of all-cause 30-day readmission rates also showed patients who followed up within a week of discharge had 58% fewer readmissions than those in the control group.
As health systems are incentivized to reduce readmissions and shift more care to outpatient settings, care coordination is more important than ever. Hospitals that are able to drive outpatient services and improve population health will be in the best position to survive in a value-based care environment.
“Hospitals [of the future] will primarily be ICUs and ORs, and the rest of care will be done in the convenience of the home,” Dr. David Tsay, associate CIO at the New York-Presbyterian Innovation Center, said at the U.S. News & World Report’s Healthcare of Tomorrow conference last month.
Improved care coordination is a key way to improve quality and cut costs. The researchers noted an email based system has the advantage of not requiring high-cost EHR systems or large amounts of provider training.
Prior to the study, hospital staff were spending more than two hours per patient on care coordination and seeing less than 40% of patients follow up on postdischarge care. After the study, inpatient staff reported improved ability to provide patients with follow-up information (86%), better communication with outpatient teams (67%), easier scheduling (80%) and a 50% drop in time spent coordinating care.
Primary care teams also saw workflow efficiencies and improvements in care coordination. The two-year pilot study was a collaboration of San Francisco Health Network, Zuckerburg San Francisco General Hospital and the University of California-San Francisco.
“Potential advantages of this system include privacy, information access, and cost,” the researchers write. “Existing email servers provided secure institutional email in compliance with Health Insurance Portability and Accountability Act regulations. Email as a method is ubiquitous and provides an electronic record, which providers can return to after hospitalization. Perhaps most importantly, this intervention succeeded for highly vulnerable patients in a large, geographically distributed public safety-net health system without an enterprise EHR system and did not require the multiple years or many millions of dollars required to fully implement such a system.”