Why home healthcare workers need access to hospital EHRs

With fewer than half of HHC clinicians having the ability to view patient data in an EHR, new research finds giving them the option could reduce medical errors. 
By Nathan Eddy
10:20 AM
nurse home care

Major gaps in communication exist between hospital and home health care (HHC) clinicians, which could lead to potentially deadly medical errors, a University of Colorado Anschutz Medical Campus study found.

WHY IT MATTERS

The study that concluded providing electronic health record access for HHC clinicians would be a promising solution to improve the quality of communication.

Although almost all (96 percent) indicated that internet-based access to a patient's hospital record would be at least somewhat useful, fewer than half reported having access to EHRs for referring hospitals or clinics.

Among respondents of the study, which surveyed 50 HHC nurses, managers, administrators and quality assurance clinicians, 60 percent reported receiving insufficient information to guide patient management in HHC, and 44 percent reported encountering problems related to inadequate patient information.

More than half of respondents (52 percent) indicated patient preparation to receive HHC was inadequate, with patient expectations frequently including extended-hours caregiving, housekeeping, and transportation--beyond the scope of HHC.

Respondents with EHR access for referring providers were less likely to encounter problems related to a lack of information (27 percent versus 57 percent without EHR access).

"We have heard of medication errors occurring between hospitals and home health care providers," the study's lead author Christine Jones, an assistant professor at the University of Colorado, said in a statement. "As a result, patients can receive the wrong medication or the wrong dose. Some home health providers don't get accurate information about how long to leave a urinary catheter or intravenous line in."

Nearly six in 10 (58 percent) of respondents said the recommendation of additional tests by hospital clinicians was the communication domain most frequently identified as insufficient.

Jones also noted additional studies have found extremely high rates of medication discrepancies (94 percent – 100 percent) when referring provider and HHC medications lists are compared, noting that if these issues are arising in Colorado, they could signify a national problem.

ON THE RECORD

"For hospitals and HHC agencies seeking strategies to improve communication, this study can provide targets for improvement," Jones said. "Future interventions to improve communication between the hospital and HHC should aim to improve preparation of patients and caregivers to ensure they know what to expect from HHC and to provide access to EHR information for HHC agencies.”

The study, published in the Journal of the American Medical Directors Association, suggested targeted education of hospital staff about what home health clinicians actually provide to patients and caregivers to avoid frustration.

Just 12 percent of respondents reported positive experiences when accessing the Colorado Regional Health Information Organization (CORHIO) about hospital admissions.

Nathan Eddy is a healthcare and technology freelancer based in Berlin.

Email the writer: nathaneddy@gmail.com

Twitter: @dropdeaded209