M. Cheung1, P. Kuo1, A. Cobb1 1Loyola University Chicago Stritch School Of Medicine,Maywood, IL, USA
Introduction:
While the technology industry makes improvements in software, the healthcare industry still lags far behind in the adoption of such advancements. Electronic medical record (EMR) interoperability is specifically important due to the fluidity of care a patient may receive from multiple sources. We hypothesized that transplant patients who received care at hospitals with high EMR interoperability scores would have shorter adjusted length of stays (aLOS).
Methods:
We utilized the 2013 HCUP State Inpatient Database (SID) for New York and Washington, and identified roughly 2000 patients who had received a heart, lung, pancreas, spleen, kidney, or bone marrow transplant. We created interoperability scores between 0-44 by summing the answers to questions designated as pertaining to Health Information Exchange on the 2013 American Hospital Association Information Technology (AHAIT) survey. We calculated the aLOS by dividing the unadjusted LOS by major severity diagnostic related group (MS-DRG)-based weights from the Centers for Medicare & Medicaid Services (CMS), and calculated the geometric means of the aLOS in order to diminish the impacts of outliers. We then correlated the calculated interoperability scores with the mean aLOS.
Results:
We found that the mean aLOS for transplantation patients decreased as interoperability score increased, within 95% confidence intervals. Adjusted length of stays of patients receiving care at hospitals with the worst interoperability score of 12 were 3.33 times longer than at hospitals with the highest interoperability score of 32.5 (p<0.001).
Conclusion:
MS-DRG weights are calculated based on expected hospital cost and severity of the patient’s disease state. Therefore, aLOS serves as an indirect proxy for efficiency related to cost as well as efficiency related to time. Our findings, although not causal in nature, suggest that hospitals could save significant time and money by increasing their ability to exchange health information between different groups and facilities.