Amedisys Chief Medical Officer, Michael Fleming, MD, FAAFP Urges The Medical Community To Focus On Collaborative Care With Post-acute Providers To Reduce Avoidable Readmissions
Michael Fleming, MD, FAAFP and chief medical officer for Amedisys Inc. (NASDAQ: AMED), a national leader in health care at home, responded today to the Wall Street Journal article “Return Patients Vex Hospitals,” the Journal of the American Medical Association ( JAMA) studies on reducing avoidable readmissions, and Harlan M. Krumholz, M.D.’s Perspective piece in the January 10, 2013 issue of the New England Journal of Medicine, “Post-Hospital Syndrome – An Acquired, Transient Condition of Generalized Risk.”
The Wall Street Journal article highlights the one percent financial penalty the Centers for Medicare and Medicaid Services has initiated for hospitals that have higher-than-predicted rates of readmissions for heart failure, acute myocardial infarction and pneumonia patients. It also noted several studies published in the online version of JAMA, which suggest that poor coordination among different providers after patients leave the hospital is largely to blame for many readmissions, and the focus should be on improving that care.
The New England Journal of Medicine article highlights challenges of recovering after a hospital stay, not from the patient’s initial diagnosis, but also from the general risk of adverse health events and physiological stress patients experience in a hospital. Krumholz cites specific stressors such as lack of sleep, disruption of circadian rhythms, changes to their diet, pain, discomfort and mentally challenging situations that result in “post-hospital syndrome.” He urges the medical community to recognize the issue and focus on interventions to promote recovery early in the recovery period that may reduce the period of vulnerability. Ultimately, he calls for “…expanded efforts to reduce readmissions during this high-risk period, making hospitalization less toxic and promoting the safe passage of patients from acute care settings.”
Amedisys recommends hospitals seeking to reduce avoidable readmissions look at a comprehensive care transitions program as well as other mission-critical interventions including:
- RN visit within 24 hours of patient discharge from the hospital
- Medication reconciliation
- Medication therapy management
- Real-time information exchange through electronic medical records across the care continuum
- Telemonitoring / telehealth for certain conditions
- Pre-determined transfer and care plan protocols
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