By Bettina Experton, MD, MPH
On January 1, California became the latest state to codify the important role of caregivers. California joined New York and 17 other states in requiring that hospitals: identify patients' caregivers; inform caregivers of a patient's discharge date; and provide caregivers with discharge instructions about a patient's needs, such as medications and home care.
While this is an important step that should help improve clinical outcomes and reduce preventable hospital readmissions, the fact remains that most hospitals continue to send patients – and now their caregivers – home with hard copy, paper discharge instructions. The potential for losing, misplacing, or forgetting this important information and the likelihood of adverse follow up care are very high.
For the most part, discharge instructions are printed directly from the hospital’s EMR system. Thanks to the Meaningful Use EHR Incentive program, more than 90% of all US hospitals are using federal government-certified EMR systems, which can securely send transition of care documents to other providers using the DIRECT secure messaging function embedded in certified EMRs. Why not utilize the widely available DIRECT function to transmit the same documents, which include discharge instructions, to patients and their caregivers?
Consumers have a choice of various DIRECT-enabled personal health record (PHR) applications which automatically give them a DIRECT address so they can receive EMR summaries or other provider generated electronic document such as hospital discharge instructions.
For the hospital discharge planning nurse, it only takes the entry of a patient or family caregiver’s DIRECT address in the DIRECT transmit field of their EMR to electronically send discharge instructions. These instructions can be immediately received by the patient or caregiver at the time of discharge by pushing these instructions to the patient’s smartphone running a DIRECT enabled mobile PHR such as iBlueButton.
Today, hospital staff can ensure that accurate, important discharge information is sent to our mobile devices. With the right information on-hand, family and professional caregivers can guard against losing this important information – and the hospital can make compliance more likely.
An estimated 40 million Americans have cared for a relative during the past year, according to a 2015 study by the National Alliance for Caregiving and AARP. With this new law, California recognizes the important role caregivers have in ensuring a successful recovery and safe transition of care. By putting standard-based technology, especially mobile tools, in the hands of patients and their caregivers, we can ensure that the law’s intent – improving quality of care after discharge – is realized. Patients and caregivers can become key participants in healthcare, rather than simply recipients of information, enabling health information exchange for optimum care coordination and safe transition of care.
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