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The Hospital Readmissions Blame Game

hospital readmission
Associate Vice President Sales, Provider Market

Much has been written in the news and healthcare industry recently about reducing hospital readmissions. However, the jury is still out on the source of the readmissions revolving door.  What we do know is that readmissions are one of the greatest drains on health system resources to the tune of $41.3 billion dollars according to the Agency for Healthcare Research and Quality.

There is growing recognition that social determinants of health are central to the health and wellness puzzle for the U.S. healthcare system. This includes reducing readmissions through understanding barriers to care in the patient’s life at home. But while many healthcare industry executives are aware of the impact of social determinants of health on populations, there are no clear strategies for how to operationalize its use.

So it begs the question…what other complementary information or data governance can we look to in pre-empting readmissions?

The Link Between Provider Data and Hospital Readmissions

Let’s consider the information needs at the point of discharge, specifically provider contact information. Forty percent of provider records have outdated or missing information and 30% of physician affiliations change each year. There is a very high likelihood that inaccurate provider contact information reduces efficient patient and physician communication. This impacts quality of care and patient follow-up after discharge.

Can we relate those metrics directly back to readmissions? Not yet, but there is a strong case that inaccurate discharge data can lead to redundant treatment, lack of follow up, and frustration of and lack of coordination of care for the patient.

A provider data cleansing and governance strategy could enable hospitals and health systems to improve patient and provider experience. It can also improve quality and outcomes and potentially lower costs. More research is needed on how those costs tie directly to readmissions. Coordination of care and communication at discharge are paramount to successful outcomes, so the connection seems likely.

As the Office of the National Coordinator for Health IT (ONC) lays down the admission, discharge and transfer data regulations, I suspect we will see more urgency around connecting the dots, both on provider data accuracy and the real answer to reducing readmission.

Learn more about how poor provider data quality can costs health systems millions in patient care.

The DNA of Healthcare

At LexisNexis Risk Solutions, our goal is to provide the healthcare industry with insights and innovations to improve outcomes, grow market share, reduce fraud and increase compliance.

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