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Electronic Medical Record Reporting Enhances Proactive Psychiatric Consultation
Christine T Finn1, Devendra Thakur1, Katherine M Shea1
1Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, NH.
Psychosomatics
|August 2, 2018
Summary
An automated electronic medical record tool can identify general hospital patients needing proactive psychiatric interventions. This early identification may reduce hospital stays and improve patient outcomes.
Area of Science:
- Psychiatry
- Health Informatics
- Hospital Administration
Background:
- Psychiatric and substance use disorders in general hospital inpatients increase length of stay and costs.
- Proactive psychiatric consultation models can effectively manage these issues.
- Methods for selecting patients for proactive interventions require further study.
Purpose of the Study:
- To develop an automated screening tool using electronic medical records.
- To identify patients who would benefit from proactive psychiatric consultation.
Main Methods:
- An automated daily report was created using electronic medical record and billing data.
- The report utilized discrete data fields including diagnoses, orders, and nursing care plans.
Main Results:
- Over 9 months, the report flagged 2177 patients (19%) for potential psychiatric intervention.
- 367 patients were confirmed as likely to benefit, with 139 randomized to proactive consultation.
- Patients receiving "treatment as usual" who later needed consultation had it requested an average of 4 days after being flagged.
Conclusions:
- An automated, electronic medical record-based report is feasible for selecting patients for proactive psychiatric interventions.
- Early identification of patients can potentially decrease length of stay and enhance patient outcomes.
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