Most healthcare providers didn’t choose their careers because they were eager to spend time chasing down clinical documents for their patients. However, the current reality is that the process of clinical document retrieval is often time-consuming, burdensome, and too slow. Providers, payers, and care coordinators expend resources and time calling, faxing, logging into various portals, and even using mail to access critical information about patient medical records.
For accountable care organizations (ACOs) involved in value-based care arrangements, discharge document retrieval is of particular importance. When a patient is discharged from an inpatient hospital stay, ACO care team members access discharge documents to provide adequate support to prevent issues that could lead to a readmission and help lower healthcare costs. More importantly, decreasing time spent “chart chasing” means increasing the time providers spend doing what truly matters: caring for patients to improve their health outcomes.
Discharge Documents Are Critical in Value-Based Care Arrangements
When a patient is being discharged from a stay, the treating providers create discharge documents that are intended for the aftercare providers. While the exact contents of discharge documents may vary, they usually contain important clinical information, including: patient demographics, contact information, primary care provider (PCP) details, the reason for admission, diagnoses, labs/test results, level of care received, name of the treating physician, medications, discharge destination, and more to support the patient’s transition to the next care setting or back home.
Ensuring discharge documents make it to the aftercare provider is crucial to preventing a readmission—whether the next step is to visit a PCP, stay in a skilled nursing facility (SNF), receive home care, or transition to an outpatient setting. Without these discharge documents reaching aftercare providers, it becomes difficult to conduct timely follow-up and can impact quality of care. A review of nearly 88,000 hospital discharge summaries found that for every three days discharge documents were delayed, there was a 9% higher risk of readmission. Another analysis concluded that the risk of readmission drops by 26% when patients have an aftercare visit with a caregiver who has access to discharge documents.
Making sure that aftercare providers can easily and quickly access discharge documents is a key strategy in preventing readmissions for accountable care organizations (ACOs) involved in value-based care arrangements. Centers for Medicare & Medicaid Services (CMS) has been leading the transition to value-based reimbursement models that shift away from the current fee-for-service model to reimburse providers based on the quality of care and patient outcomes. The Medicare Shared Savings Program (MSSP) is one of the alternative payment models that rewards providers when they coordinate care to prevent a readmission. This reduces overall cost of care for everyone involved—something critical for Medicare, which is projected to spend over $1.5 trillion in healthcare costs by 2028. In a report on successful ACOs, Medicare found that strategies for increasing MSSP opportunities include preventing avoidable rehospitalizations and leveraging technology to improve health information sharing among providers.
The Current State of Discharge Document Retrieval
Accessing discharge documents in a timely manner is at the core of successful care transitions. However, as it stands, discharge document retrieval is often disjointed, burdensome, and delayed—none of which bodes well for ACOs trying to improve patient outcomes post-discharge. According to Healthcare Information and Management Systems Society (HIMSS), common reasons that care coordination documents do not reach aftercare providers include obstacles like interoperability issues, poor integration, wrong or missing contact information, and lack of a set timeframe for sending discharge documents.
A survey of members of the American Academy of Family Physicians found that doctors’ access to discharge documents ranged among respondents:
- 27.5% reported availability 0 – 40% of the time
- 41.4% reported availability 41 – 80% of the time
- 31.1% reported availability 80% or more of the time
Inconsistent access to discharge documents impacts the ability of aftercare providers to support patients following a hospitalization, particularly when it comes to coordinating care and clinical decision-marking. When discharge documents are unavailable, providers may have to rely on the patient to relay the discharge information themselves. However, several studies have shown that patients often struggle to understand and follow discharge instructions, leading to poor health outcomes. In other cases, care teams have to manually search for discharge documents, which can waste time, expend resources, and delay important care coordination opportunities.
Benefits of Automated Access to Discharge Documents
Rather than burden providers with chart chasing, what if discharge documents appeared directly in the workflow of the care team when a patient left the hospital? This is where health information technology comes into play. Health IT providers can partner with health information exchanges and national health information networks to find discharge documents and send them directly to the electronic health record (EHR) system the care team uses.
By doing this automatically at the time of discharge, providers and care coordinators no longer have to track their patients manually, contact the hospital, and try to gain access to the discharge documents by phone, fax, or even mail. Automated access to discharge documents can help by:
- Reducing staff time spent on manual clinical records retrieval
- Reducing medication discrepancies and adverse events
- Reducing hospital readmissions
- Reducing redundant services
- Increasing provider satisfaction
- Increasing quality of follow-up care
- Improving quality scores
These benefits are especially important for ACOs and healthcare providers in value-based care arrangements working to increase MSSP opportunities and improve outcomes for patients in their care. Automatically receiving post-discharge medical records associated with a recent patient hospital encounter allows ACO care coordinators to jumpstart outreach for appropriate aftercare, including contacting the patient’s PCP to share the discharge documents and set up a visit.
By eliminating chart chasing, care teams are empowered to re-focus their time on patients, including improving patient outcomes, reducing costs by providing more informed care, and delivering the highest standards of quality care.
About the Author
Diana Bauza is a content writer based in the Greater Philadelphia area. She writes about products and services in the health and technology industries, with the goal of empowering consumers with quality information to help them make decisions that best serve their needs