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Poor Communication Between Hospitalists And PCPs Impacts Patients

July 31,2015

According to a recent study published in the Journal of General Internal Medicine, patient care coordination in the transition from hospital to home often suffer due to poor communication between Hospitalists and PCPs. Poor communication, or lack of communication, between providers can lead to medication errors, missed test results, readmissions and patient harm. 

Where Are The Gaps?

Collaboration between Hospitalists and PCPs is a critical component for a successful transition of care but only 23% of PCPs indicated that they had direct communication with Hospitalists. 30% of PCPs reported that they were not aware that their patient had been hospitalized and that they received discharge summaries only 42% of the time, two scenarios which have been correlated with post-discharge problems.

Hospitalists and PCPs each identified having similar challenges that impedes care coordination including:

  • Lack of time
  • Difficulty reaching other clinicians
  • Lack of a personal relationship with other clinicians
  • Lack of information feedback loops
  • Medication list discrepancies
  • Lack of clarity on responsibility for pending tests

Hospitalists additionally noted that care coordination is hindered due to difficulty obtaining timely follow up appointments for after hours or weekend discharges while PCPs noted not knowing when patients were hospitalized, not having hospital records for post-hospitalization appointments and difficulty locating important information in discharge summaries. (1)

Is There A Correlation Between Poor Communication And Post Discharge Problems?

Several articles have highlighted the need for improved communication between hospital and community providers as it relates to quality of care. A study in the Journal of Hospital Medicine reported that patients were twice as likely to report a problem following discharge if their PCP was unaware of their hospitalization. (2)In another study,van Walraven, et al. concluded that the risk of re-hospitalization may decrease when patients are assessed following discharge by PCPs who have received the discharge summary. (3)Additionally, the prevalence of medical errors related to the discontinuity of care from the inpatient to outpatient setting is high with close to 50% of patients experiencing one or more errors related to medication, tests pending at discharge and work ups. (4)

In addition to clinical issues, the inadequacies of care transitions have adverse economic implications to the U.S. health care system: 

  • Medication errors harm an estimated 1.5 million people each year in the United States, costing the nation at least $3.5 billion annually. 
  • One study found that, on discharge from the hospital, 30% of patients have at least one medication discrepancy. 
  • According to another study, one in five U.S. patients discharged to their home from the hospital experienced an adverse event within three weeks of discharge. Sixty percent were medication related and could have been avoided. (5) 

How Can Things Be Different?

Clearly there is a need to improve communication between hospital-based and community providers. However the prevailing communication modalities in healthcare remain antiquated and inefficient and lead to wasted time, unnecessary costs and a negative impact on patient outcomes. A HIPAA compliant text-messaging platform can improve care coordination by allowing:  

  • PHI can be openly shared between Hospitalists and PCPs instantly and securely 
  • Patient notes and plans can be sent through the secure tunnel and uploaded to any EHR
  • Text-based discharge care summaries can be shared between Hospitalists and PCPs
  • Medications prescribed and tests pending at discharge can be communicated rapidly and directly

IM Your Doc is an encrypted, secure, HIPAA-compliant platform that allows Hospitalists and PCPs to share, in real-time, PHI, images, documents and encounter notes, all on their mobile devices and desktops, through the speed and convenience of text.

For further information on IM Your Doc, visit www.imyourdoc.com or call 1-800-409-8078.

1.” Failure to Communicate: A Qualitative Exploration of Care Coordination Between Hospitalists and Primary Care Providers Around Patient Hospitalizations”, Journal of General Internal Medicine, 2015, April, Volume 30, Issue4:417-424

2. “ Problems After Discharge and Understanding of Communication with Their PCPs Among Hospitalized Seniors”, Journal of Hospital Medicine, 2010, September 5(7): 385-391

3. “Effect of Discharge Summary Availability During Post Discharge Visits on Hospital Readmission”, Journal of General Internal Medicine, 2002, March 17(3): 186-192

4. “Medical Errors Related to Discontinuity of Care From an Inpatient to Outpatient Setting”, Journal of General Internal Medicine, 2003, August 18(8): 646-651

5. “Improving Transitions of Care”, National Transitions of Care Coalition, September, 2010