Poster Abstracts
Meet the authors at the poster presentation session breakfast , Tuesday from 7:30 to 8:30 am in the Solana ABCD Ballroom . Abstract number indicates poster location .
1 ) Facilitators and Barriers to Urologists ’ Engagement with the eConsult Service at Dartmouth-Hitchcock
John Anagnost , MS and Jacqueline Kihwele , MD , MPH The Dartmouth Institute for Health Policy
Background : Electronic consultations ( eConsults ) allow primary care physicians to ask questions to specialists regarding the care management of individual patients through a shared electronic health record system . Although specialists ’ perceptions and experiences with eConsults have been thoroughly examined in the Canadian and VA health systems , similar rigorous qualitative work has yet to be done in the context of academic medical centers in the US which are characterized by a balance between research , patient care , and teaching .
Methods : Participants were recruited based on their level of engagement with eConsults at the AMC : established users ( n = 3 ), new users ( n = 2 ), and non-users ( n = 3 ). Qualitative semistructured interviews were conducted from February 2018 to March 2018 . Data analysis was focused on familiarization , coding , and theme development . Some codes were theorydriven based on previous literature while other codes emerged from the data specific to interviewees ’ experiences . Thematic analysis followed a modified grounded-theory framework .
Results : Participants generally perceived eConsults outside of their sub-specialties to be less interesting and more time consuming . Similarly , most felt that eConsults were “ extra ” work , lacked a financial incentive , and required a similar amount of effort and time as face-to-face visits of comparable complexity . However , participants were interested in eConsults because they facilitated quick and effective education of primary care physicians- having a downstream effect of improving referral prep work , decreasing redundant questions , limiting unnecessary referrals , and reducing patient travel . Recommendations to improve engagement included integrating eConsults into normal workflow , increasing the number of providers doing eConsults , distributing general eConsults among mid-level providers , and separating out paychecks for eConsults .
Conclusions : Optimal ways to balance these different factors should be considered in future strategies to improve specialist engagement with eConsults , especially in settings driven by productivity measures like RVUs .
2 ) Transition Care Management : Improving Care by Decreasing Readmissions Through Transition Care Management Program
Cindy Bobay , MSN , CPHQ Atrium Health ( formerly Carolinas Healthcare )
Background : Carolinas HealthCare System ( CHS ) implemented a Transition Care Management ( TCM ) program with care managers making follow-up phone calls to patients with high or moderately high risk for readmission .
Methods : Cerner ’ s risk prediction tool generates the patient list for calls . The care managers contact the patient within two business days of discharge , review the medication reconciliation , discharge instructions , transportation , any social needs , and documents assessment in the HealthECare discharge tool . The follow-up appointment is verified or made within the required time from discharge and enters the referral source as TCM in the scheduling systems . The Central Billing bills TCM calls end of the month reimbursing physician practices . All patients are contacted regardless of payer source or facility . The CPT code 99495 requires a face-toface visit within 14 calendar days of discharge , and CPT code 99496 requires a face-to-face visit in seven calendar days of discharge .
Results and Conclusions : The TCM discharge phone call program reduced readmissions from Jan 2017 through April 2017 with 4,392 calls completed from 5,296 discharges . There were 4,181 appointments with 3,775 arrived for a 90 % arrival rate . Only 56 patients werereadmitted before appointment , a 0.01 % readmission rate . The TCM program improves followup appointment compliance reducing readmissions .
3 ) Creating a Telebehavioral Health Strategy
Geoffrey Boyce , MBA InSight Telepsychiatry
Telepsychiatry has made its impact on the healthcare market , but often it can be thought of as a “ band aid ” for the immediate psychiatry needs of an organization . It is now time to think of telepsychiatry , with its trend of increased usage across the care continuum , as a long-term strategy that can help an organization meet both its immediate needs , as well as help address and
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