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Flagstaff Medical Center

How Automation Prevents Readmissions in Arizona

Northern Arizona Healthcare, like many of its counterparts, battles recurring readmissions. But through a combination of solutions and teamwork, it managed to nearly halve its numbers.

One of its two hospitals, Flagstaff Medical Center (FMC), sees roughly 70,000 patients a year. More than 9,000 of those FMC patients were readmitted congestive heart failure patients.

The 2009 Centers for Medicare and Medicaid data notes the mean cost for a congestive heart failure (CHF) readmission is $13,000 and one out of every four CHF patients is readmitted to the hospital within 30 days of leaving.

In 2011, FMC’s 30 day readmission rates for CHF were much lower – 13.6 percent. But three years later, the FMC team nearly halved it – to 7.1 percent.

FMC’s social work manager Tiffany Ferguson credits the drop to time saved in other places, and coordinated care between inpatient and outpatient care managers.

The hospital began addressing readmissions with the BOOST methodology in 2012. Despite being on Cerner’s electronic health records (EHR), the readmissions process was paper-based. It took clinicians as much as two hours to evaluate a single CHF patient case and risk.

Then FMC enhanced its EHR by implementing Cerner Acute Care Management, and using the Cerner Readmission Prevention with licensed BOOST content. “The alerts identify a patient as high-risk,” said Ferguson. “The system catches it for us.”

With integrated workflows, the time it took to assess an admission dropped from two hours to a matter of seconds. “Because things are happening behind the scenes,” Ferguson said, “I don’t have to manually do it all.”

Now the readmission solution identifies high and moderate readmission risk patients across the entire hospital population.

Ferguson says her team can screen its entire patient load – 23 patients per care manager – in an hour. “I don’t have to delve into a chart,” said Ferguson. “I get a snapshot of it all, right in front of me.”

FMC is now using the time savings to expand its readmission risk assessment to other high-risk patients. The hospital has now reduced all-cause readmissions by 45%.

Technology bridged the care gap, said Ferguson. “Cerner has helped us put patient care where it belongs – in the patient room, not the computer.”

In late March, Cerner and NAH will be presenting on this topic at the Society of Hospital Medicine Conference. Ferguson also spoke on FMC and NAH’s reduced readmissions strategy at 2014 Cerner Health Conference.

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.