HHS: EHRs, Financial Incentives Have Helped Increase Patient Safety As HACS Decline 17 Percent

Dec. 2, 2015
The widespread adoption of electronic health records (EHRs) has helped reduce hospital-acquired conditions by 17 percent over the past four years, resulting in 87,000 fewer patient deaths in 2014 alone, according to data collected by the Agency for Healthcare Research and Quality (AHRQ).

The widespread adoption of electronic health records (EHRs) has helped reduce hospital-acquired conditions by 17 percent over the past four years, resulting in 87,000 fewer patient deaths in 2014 alone, according to data collected by the Agency for Healthcare Research and Quality (AHRQ).

AHRQ, which operates under the U.S. Department of Health and Human Services, notes that hospitals have made “substantial progress in improving safety” and credits several likely contributing causes, including improved use of EHRs and financial incentives.

The AHRQ report states that hospital patients experienced 2.1 million fewer hospital-acquired conditions (HACs) from 2010 to 2014, which also saved the healthcare system approximately $19.8 billion in costs.

However, AHRQ data also indicates that after three years of declines in the number of avoidable HACs, that rate hit a plateau in 2014. Data shows that there were 145 HACS per 1,000 discharges in 2010 and that figure dropped to 121 per 1,000 discharges in 2013 and has held steady in 2014.

HACs include adverse drug events, catheter-associated urinary tract infections, pressure ulcers, surgical site infections, central line-associated bloodstream infections, post-op venous thromboembolisms and falls.

About 40 percent of the reduction in HACs is from adverse drug events, about 28 percent from pressure ulcers, and about 16 percent from catheter-associated urinary tract infections, according to AHRQ. These HACs constituted about 34 percent, 27 percent, and 8 percent, respectively, of the HACs measured in the 2010 baseline rate.

“Although the precise causes of the decline in patient harm are not fully understood, the increase in safety has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events. This effort has been spurred in part by Medicare payment incentives and catalyzed by the U.S. Department of Health and Human Services (HHS) Partnership for Patients (PfP) initiative,” the agency said in the report.

AHRQ notes that hospitals have made “substantial progress in improving safety” and credits several likely contributing causes, such as financial incentives created by the Centers for Medicare & Medicaid Services (CMS) and other payers’ payment policies as public reporting of hospital-level results and technical assistance and catalytic efforts of the HHS PfP initiative led by CMS.

“Numerous other public and private initiatives to improve healthcare quality and patient safety were implemented during these years; for example, the widespread implementation and improved use of Electronic Health Records at hospitals,” the agency stated in the report. “And crucially, the progress was made possible by the results of investments made by the Agency for Healthcare Research and Quality in producing evidence about how to make care safer, investing in tools and training to catalyze improvement, and investments in data and measures to be able to track change.”

However, AHRQ noted that there is “still much more work to be done”

“The Interim 2014 HAC rate of 121 HACs per 1,000 discharges is the same as was seen in 2013, and it means that in 2013 and 2014 almost 10 percent3 of hospitalized patients experienced one or more of the HACs we measured. That rate is still too high,” the agency stated in the report.

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