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Communication Needs an Upgrade

Research that shows 1 in 3 adult patients does not see a physician within 30 days of discharge is the latest sign that more communication is needed between hospital physicians their community colleagues, a researcher says.

A report from the National Institute for Health Care Reform (NIHCR) found that after 90 days, 17.6% of adults still have not seen a physician, nurse practitioner, or physician assistant, says Anna Sommers, PhD, senior health researcher at the Center for Studying Health System Change, which conducts research for NIHCR. She adds that better communication between hospitalists and PCPs or specialists can be encouraged by important health information technology (HIT), but the process isn’t a simple fix.

“That’s not just about getting a shared medical record in place,” she adds. “A medical record, even for just one inpatient stay, can be large. How does the doctor sift through all that? … [Technology] can be part of the solution, but I think everyone is still learning how to use the technology and developing interfaces that are useful to the users. It’s an evolving process.”

Hospitalists have helped address transitional-care issues with initiatives including post-discharge clinics, but more work needs to be done, Dr. Sommers says. She adds that the depth of the readmission issue is particularly striking as the research found that non-elderly adults with public coverage, a population that historically has higher rates of chronic conditions, were no more likely to see a doctor with 30 days of discharge than a person with private insurance.

“This problem is occurring all over the place,” Dr. Sommers says. “It’s a systematic problem, not a problem of one population in the health system.”

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