Minimal progress in what is a challenging problem for healthcare facilities in preventing readmission of patients. Surgical patients fared the best with a 12.7% readmission rate which was unchanged but in the top 3 killer category Congestive Heart Failure remained a recalcitrant problem with 1 in 5 patients returning to hospital - up slightly from the previous years.
The good and bad news is the looming ICD10 coding requirements will increase the visibility of this failure in the care system.
Good news in the long term as to improve anything we have to be abel to measure it, the bad news that it will shine an uncomfortable spot light on failures in the coordination of care.
THe incentives are in place for facilities as the government steps up the pressure with penalties for facilities with readmissions for heart attacks, heart failure and pneumonia coming in 2012. But this is just the tip of the iceberg of incentives and penalties.
Fundamental to these changes is the need for clinical data and the ability to report on progress that can only be achieved with discreet data on all patients. Some of this will come from direct data entry but the vast majority is currently locked away in the narrative and bridging this gap without burdening the clinician with data entry tasks will be essential.
Recent advances in the ability to extract and tag discreet clinical data contained in the narrative has been shown and is emerging as key "must have" technology for providers. Increasingly this is being built on the foundation of speech recognition that has clearly reached the point of wide spread adoption and acceptance in the clinical community. Demonstration projects and solutions are already showing the ability to satisfy the data reporting requirements directly from dictated clinical reports using technology to extract the data instead of asking the clinicians to enter the data manually through forms and data entry tools.
These tools will be increasingly important as we are pushed along the path towards higher quality lower cost care which must be built on measurable clinical data for each and every patient seen and treated in the healthcare system.