Care Transitions Might BeHazardous To Your HealthInadequate Communication BetweenHospitals and LTC Facilities Lead ToPatient Errors

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Individuals residing in long term care settings are often transferred from one care setting, level of care or care team to another. When transitions in care occur, the individual will likely be seen by multiple providers. These providers often make medication changes which, particularly for older adults, puts them in a vulnerable position to complication and error.

Communication is critical for positive patient outcomes but shortcomings exist in nursing home to hospital and hospital to nursing home transitions.

The Oregon Patient Safety Commission noted in a 2016 report that over 25% of nursing home residents are transferred at least once per year to an emergency department. Communication about the care of the resident is often lacking. In fact about 10% of nursing home-to-ED patients are transferred without any documentation and for the remaining 90%, important care information is missing.(1)

Care within a nursing home is often adversely a�ected due to poor communication. Most nursing home RNs rely almost entirely on discharge information provided by the hospital when transitioning patients to a nursing home. Communication of such information however is often inadequate. Problems regularly arise with medication due to the lack of necessary prescriptions, limited or no medical history and, sometimes, the wrong information is provided regarding the current health status of patients. Due to the miscommunication between hospitals and nursing homes, nursing home sta� report that they have to consistently make phone calls for clari�cation about medical history and medication, and su�er delays in administering medications as a result.(2)

25%of nursing home

residents transferred at least once per year

to an emergency department

10% without anydocumentation

90% missingimportant careinformation

7650 SE 27th Street, Suite 200 Mercer Island, WA 98040 | 1 (800) 409 8078

Miscommunication or poor communication doesn't just occur between disparate facilities. It happens right within a facility's four walls, putting patients at risk.

According to the National Transitions of Care Coalition, medication errors harm an estimate 1.5 million people per year in the United States, costing the nation at least $3.5 billion annually. Adverse drug events attributable to medication changes occur in 20% of transfers between hospitals and Skilled Nursing Facilities (SNF), with close to half caused by a discontinuation of medication during the hospital stay.(3)

One-Third of Skilled Nursing and Rehab Facility Patients Harmed in Treatment

Studies conducted by the O�ce of the Inspector General, Department of Health and Human Services published in February 2014 and July 2016 analyzed care in SNFs and non-hospital a�liated rehab facilities, revealing strikingly similar �ndings.

Approximately one in three patients in each environment su�ered a medication error, bedsore, infection or some other type of harm as a result of the care they received, citing substandard treatment, inadequate monitoring and delays or failure to provide needed care as the contributors to patient harm. Fifty to sixty percent of the incidents were determined to be preventable.

One quarter of the harmed rehab patients had to be admitted to an acute care hospital at a cost to Medicare of $7.7 million for the month analyzed.

More than half of the skilled nursing facility patients that were harmed had to be admitted to a hospital at a cost of $208 million for the month studied, representing about 2% of Medicare's total inpatient spending.(4) (5)

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7650 SE 27th Street, Suite 200 Mercer Island, WA 98040 | 1 (800) 409 8078

www.imyourdoc.com

Non-Secure Faxes are often misplaced and can create HIPAA risks and delays in patient care.

Delayed Responses from the Medical Director to questions from the facility sta� wastes time, money and can negatively impact patient outcomes.

Ine�cient Accounting and Record Keeping requiring the logging of incoming and outgoing faxes does not provide a clear, documented path to track and view all messages related to a particular patient.

Time Sensitive Information Not Immediately Communicated to the Medical Director is often delayed due to phone tag, missed calls or the Medical Director's private practice commitments.

The Communication ConundrumE�cient communication between the facility sta� and Medical Director is critical to patient safety, improving outcomes and coordinating care. However, signi�cant communication ine�ciencies continue to exist in rehab facilities and SNFs:

Clearly there is a need to improve communication between hospitals and nursing homes and within rehab facilities and SNFs. Through a HIPAA compliant secure messaging platform which enables real-time, two-way communication through the speed and convenience of text, preventable harm can be avoided and care coordination improved:

How Can Things Be Di�erent?

PHI and text-based discharge summaries can be openly and securely shared between hospitals and facilities

Images of developing wounds and sores can be instantly sent by the facility sta� to the Medical Director

Documents like lab reports or test results can be sent real-time and securely for review by mobile users on the go

Status of chronic conditions, new symptoms or changes in condition can be communicated to the entire care team

Progress notes and care plans can be sent through the secure tunnel and uploaded to any EHR

Medication questions and changes to medication can be communicated rapidly and directly

(1) Oregon Patient Safety Commission:” Care Transitions: Strengthening Communication, Improving Outcomes”, 2016(2) Jonathan Rosenfeld, Nursing Home Law Center, “Poor Communication Alleged in Nursing Home Patient's Death”(3) E. Thompson, RN, CMC, “Evaluating the Pitfalls and Barriers to Reduce Rehospitalizations”, October 2013(4) ProPublica, “Rehab Hospitals May Harm a Third Of Patients, Report Finds”, July 2016(5) ProPublica, “One Third of Skilled Nursing Patients Harmed in Treatment”, March 2014

7650 SE 27th Street, Suite 200 Mercer Island, WA 98040 | 1 (800) 409 8078

www.imyourdoc.com

To make sure a secure messaging solution will work for you, it needs to be easy so it will be adopted by your organization, require no IT interventions or long training and be a�ordable even if you haven't included it in your annual budget.

Real-time secure messaging closes the communication gap, improving e�ciency and care coordination while saving time, money and...preventable patient harm.

When Choosing A Secure Messaging Provider