Collection of patient-reported outcomes by use of tablet technology and automatic transmission into the electronic chart with data storage for later use is feasible. This process can overcome many of the inefficiencies associated with paper questionnaires.
Introduction:
Post-hospitalization outpatient follow-up visits are important components of high quality care for patients with cardiovascular diseases. However, challenges in scheduling appointments prevent many patients from obtaining timely post-discharge care.
Hypothesis:
We hypothesized that a streamlined process for follow-up appointment scheduling utilizing the electronic order entry system would be an effective means of scheduling post-discharge visits for many inpatient admissions.
Methods:
In effort to increase patient access to post-discharge care, we designed a process for electronic provider-ordered follow-up appointment scheduling that was implemented on cardiology inpatient services in a large academic medical center in January 2014. During a patient hospitalization, providers were given the capability to order a follow-up appointment via the electronic order entry system. The order allows providers to designate the time-frame for follow-up, desired outpatient providers, and patient scheduling preferences. These orders are electronically transmitted to appointment schedulers, who schedule visits within two hours of order entry six days per week. Appointment information is reviewed with patients prior to discharge.
Results:
During the first 12 months after implementation (January to December 2014), 3406 follow-up appointment orders were placed for 2749 patients, or 1.24 visits ordered per patient. At least one visit ordered for 49.8% of the total 5534 cardiology admissions. The percentage of admitted patients for whom an outpatient visit was ordered from the first through fourth three-month interval in 2014 significantly increased: 28.2%; 48.0%, 53.4%, and 63%, respectively (Figure, p<0.0001).
Conclusion:
A post-hospitalization outpatient appointment scheduling process using the electronic order entry system can be an effective method for scheduling follow-up visits for many inpatients prior to discharge.
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