A Dallas hospital that used a software program to identify heart failure patients at high risk for readmission was able to offer intensive inpatient and outpatient counseling and monitoring services to them and cut their overall rehospitalization rate by 20%.

The software program extracted real-time data from the electronic health record system at the 780-bed Parkland Memorial Hospital in Dallas and stratified heart failure patients by readmission risk within 24 hours of the initial admission.

One in four heart failure patients admitted was at the highest risk for readmission, allowing Parkland to offer multidisciplinary care transition and discharge services to these patients with minimal extra costs, according to a study of the intervention posted online July 31 in BMJ Quality & Safety (link). In the two years before the new technology was used, the safety net hospital’s 30-day readmission rate was 26.2%. That rate fell by one-fifth to 21.2% during the subsequent yearlong study period.

“This project was able to achieve the ‘holy grail’ of readmission reduction strategies,” said Ethan A. Halm, MD, MPH, senior author of the study and professor of internal medicine and clinical sciences at the University of Texas, Southwestern Medical Center in Dallas. “It reduced the population-based rate of readmission and saved the hospital thousands by redeploying limited, existing resources to the 25% of the patients at highest risk. It was so successful that what started as a research project is now part of the way the hospital does business.”