Impact of Clinical Reminders on Documentation of Compliance with CMS Core Indicators

1IPC —
The Hospitalist Company, Denver, CO
2IPC —
The Hospitalist Company, North Hollywood, CA
3ICU Medicine, St. Louis, MO
4IPC—The Hospitalist Company, North Hollywood, CA

Meeting: Hospital Medicine 2007, May 23-25, Dallas, Texas

Abstract number: 19

Background:

Congestive heart failure (CHF) is one of the most prevalent clinical conditions seen by hospitalists. Therapy with angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin II receptor ers (ARBs) have been shown to reduce morbidity and mortality from this disease. We studied the impact of computerized clinical cues at the time of completion of the discharge summary on documentation of prescription of these agents as well as documentation of contraindications to their use.

Methods:

All IPC hospitalists create a discharge summary in the IPC‐LinkR proprietary software system. Hospitalists were randomly divided into 2 study groups at the hospitalist group level. For the experimental group, if no ACEI/ARB was documented at discharge, a computerized reminder would ask for either documentation of a prescription or a reason for no prescription being made.

Results:

In the control group were 168 hospitalists caring for 2020 CHF patients. The experimental group consisted of 126 hospitalists caring for 1477 patients with CHF. Of the patients in the control group, 39% had a prescription for an ACEI or an ARB documented. In the experimental group, 50% had documentation (11% increase, 95% CI: 5%, 17%). After removal of the patients with valid contraindications to prescribing ACEIs/ARBs, the intervention group's compliance was 59%, a 20% increase (95% CI: 14%, 26%).

Conclusions:

By adding a computer‐generated clinical cue at the time of discharge for physicians caring for patients with congestive heart failure, the rate of documentation of prescription of ACEIs or ARBs can be significantly improved. In the future pay‐for‐performance health care market, methods to improve physicians' documentation of compliance with core quality measures will become increasingly important.

K. R. Epstein, IPC, stock options or bond holdings, employment (full‐ or part‐time); E. Juarez, IPC, stock options or bond holdings, employment (full‐ or part‐time); K. Loya, IPC, stock options or bond holdings, employment (full‐ or part‐time); M. Gorman, IPC, stock options or bond holdings; A. Singer, IPC, stock options or bond holdings, employment (full‐ or part‐time).

To cite this abstract:

Epstein K, Juarez E, Loya K, Gorman M, Singer A. Impact of Clinical Reminders on Documentation of Compliance with CMS Core Indicators. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 19. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/impact-of-clinical-reminders-on-documentation-of-compliance-with-cms-core-indicators/. Accessed July 17, 2019.

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