EHR vendors, AHIMA push use of clinical decision support to prevent patient falls

Data from electronic health records combined with other technologies like analytics can help pinpoint patients at risk and encourage caregivers to intervene before a fall occurs.
By Bill Siwicki
01:54 PM
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Electronic health records software can play a more prominent role in helping to prevent patient falls, AHIMA said in new research. 

EHR vendors such as Epic, Cerner and Meditech, in fact, have been working to equip doctors with tools and data to make that happen since 2015. 

But AHIMA found that “physicians caring for older adults provide recommended fall risk screening only 30 to 37 percent of the time,” in its study, “An Electronic Health Record Data-driven Model for Identifying Older Adults at Risk of Unintentional Falls.” 

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The question now is how hospitals can get that screening percentage higher both for patients’ sake and because there are billion of dollars at stake?  

A public health problem

Falls are mostly preventable. There are several things that primary care providers can do to reduce their aging patients’ chances of falling. The Centers for Disease Control and Prevention, for instance, developed the STEADI (Stopping Elderly Accidents, Deaths and Injuries) toolkit.

Based on the American and British Geriatric Societies’ Clinical Practice Guidelines, STEADI includes algorithms and tools to help primary care providers identify and manage fall risk among older adult patients.

The CDC estimates that for every 5,000 providers who adopt STEADI, over a five-year period as many as 6 million more patients could be screened for fall risk, 1 million more falls could be prevented, and $3.5 billion saved in direct medical costs. 

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Working with Oregon Health & Science University, the University of Wisconsin and the CDC, Epic developed system tools that a healthcare organization can use to implement and support STEADI. The tools screen for fall risk; assess gait, strength, and balance; conduct a full fall risk evaluation; identify patient goals; intervene; and monitor outcomes.

Epic calls this a “clinical program,” which pulls together decision support tools and other aspects of Epic’s EHR into a targeted improvement workflow based on the success of others. Epic also has a general inpatient falls prevention program developed by the Epic Nursing Collaborative. This program uses EHR system and non-system strategies to reduce falls, strategies that can be tailored to fit an organization’s needs.

The nursing-generated program incorporates best practices from each organization represented in the collaborative, including Aurora Health Care, Cedars-Sinai, Children’s Hospital of Colorado, Cleveland Clinic, Kaiser Permanente, Stanford, Texas Health Resources, University of Arkansas, University of Colorado Health, University of Iowa and the University of Virginia.

Epic is not the only EHR vendor to adopt STEADI. Other marketshare leaders including Cerner, Meditech and Allscripts have done so as well. 

What’s next? 

What the CDC, universities and EHR vendors are doing with STEADI is, of course, not a magic solution to fall prevention. 

AHIMA researchers called for implementing clinical decision support tools more deeply into EHRs as a start. That would better enable care teams to pinpoint and intervene before at-risk patients fall. 

Take El Camino Hospital in California. The 420-bed system integrated analytics and bed alerts with its EHR. The combination predicted which patients were at risk for an imminent fall and alerted nurses and case managers in real time, which was one factor that helped result in a 39 percent reduction in falls within six months of starting the program, chief nursing officer Cheryl Reinking said at the HIMSS and Healthcare IT News Big Data & Healthcare Analytics Forum in April 2017.

“Electronic health record data can be applied in clinical decision support,” AHIMA interim CEO Pamela Lane said of the association’s new report. “By leveraging the data in a way that is sensitive to the time constraints of the regular office visit and the reduction of healthcare costs, identifying patients at risk of falls can be streamlined.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com