EHR triggers: a force for improved care--and revenue

Area of Science:

• Healthcare Informatics
• Clinical Decision Support
• Health Services Research

Background:

• Process-of-care measures from Hospital Compare identify at-risk patients.
• Electronic Health Records (EHR) can integrate these measures for proactive care.
• Undetected comorbidities and complications impact patient outcomes and hospital revenue.

Purpose of the Study:

• To explore the use of EHR-based automatic triggers for patient screening.
• To establish medical necessity for improved patient care and organizational revenue.
• To assess the role of screenings in identifying complications and comorbidities at admission.

Main Methods:

• Leveraging CMS process-of-care measures.
• Implementing automatic triggers within an EHR system.
• Analyzing patient data for high-risk indicators and potential complications.

Main Results:

• EHR triggers facilitate identification of high-risk patients for targeted screenings.
• Screenings improve patient care and can increase healthcare organization revenue.
• Early detection of complications and comorbidities at admission is enabled.

Conclusions:

• EHR-integrated screening protocols enhance patient care by identifying at-risk individuals.
• Automatic triggers support clinical decision-making and financial health for healthcare organizations.
• Proactive identification of comorbidities and complications through EHRs is crucial for accurate patient management and reimbursement.