ORIGINAL ARTICLE

Integrating Health Information Technology to Achieve Seamless Care Transitions Leah Marcotte, MD,* Janhavi Kirtane, MBA,Þ Joanne Lynn, MD, MA, MS,þ and Aaron McKethan, PhD§

Abstract: Improving care transitions, or ‘‘handoffs’’ as patients migrate from one care setting to another, is a priority across stakeholder groups and health-care settings and additionally is included in national health-care goals set forth in the National Quality Strategy. Although many demonstrations of improved care transitions have succeeded, particularly for hospital discharges, ensuring consistent, high-quality, and safe transitions of care remains challenging. This paper highlights the potential for health information technology to become an increasing part of effective transitional care interventions, with the potential to reduce the resource burden currently associated with effective care transitions, the ability to spread improved practices to larger numbers of patients and providers efficiently and at scale, and, as health technology interoperability increases, the potential to facilitate critical information flow and feedback loops to clinicians, patients, and caregivers across disparate information systems and care settings. Key Words: care transitions, health information technology, medication reconciliation, discharge process, patient activation, health information exchange, meaningful use (J Patient Saf 2014;11: 185Y190)

BACKGROUND: CONSENSUS ABOUT THE NEED TO ENSURE MORE SEAMLESS CARE IN TRANSITIONS The need to address gaps in transitions of care is receiving significant policy and practical attention in Washington and around the country. As a recent review by Naylor et al. noted,1 poor care transitions are associated with unnecessarily high rates of health services use,2,3 including increased rates of potentially avoidable hospitalizations, and excessive health-care spending,4,5 as well as gaps in quality and safety. For example, in transitioning from one care setting to another, patients often experience problems with medications and are at a higher risk of experiencing other adverse clinical events.6,7 Poor transitions can also increase the likelihood that patients experience serious unmet needs8 and can be associated with patients’ poor satisfaction with care.9,10

Policy and Programmatic Activities Focused on Care Transitions Accordingly, there is much current policy and programmatic activity in this area both in the public and private sectors (Table 1). For many years, pioneering foundations and health services researchers have drawn increasing national attention to From the *Department of Medicine, University of Washington; †Beacon Community Program, Office of the National Coordinator for Health Information Technology, Washington, District of Columbia; ‡Center on Elder Care and Advanced Illness, Altarum Institute, Ann Arbor, Michigan; and § RxAnte, Inc. and Health Policy and Management, Gillings School of Global Public Health, UNC Chapel Hill, Virginia. Correspondence: Aaron McKethan, PhD, 3706 Merrimac Trail, Annandale, VA 22003(e

Integrating Health Information Technology to Achieve Seamless Care Transitions.

Improving care transitions, or "handoffs" as patients migrate from one care setting to another, is a priority across stakeholder groups and health-car...
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