Abstract 148: Initial Results from Electronic Referrals for Cardiac Rehabilitation
Background: Cardiac rehabilitation programs are an underutilized component of secondary prevention for patients with coronary disease.
Methods: With the intent of increasing cardiac rehabilitation access for inpatients after discharge, we switched the mechanism of referral for inpatients to cardiac rehabilitation from a paper-based system to an order embedded within the inpatient electronic medical record at the beginning of December 2013. We compared the monthly number of cardiac rehabilitation referrals before and after intervention with a t-test, and compared inpatient versus outpatient referrals with a chi-squared test.
Results: In a five-month pre-intervention period, cardiac rehabilitation received 307 total consults, of which 8 were from inpatients. After the intervention, over two months, cardiac rehabilitation received 131 consults, of which 34 were from inpatients. Total volume of consults from inpatients did not increase (61.4/month to 65.5/month, p = 0.335) at this early stage although proportion of consults from inpatients increased (2.6% versus 30.0%, p < 0.0001). Time trends of referrals patterns are shown in Figure 1. Of the referrals from inpatients during the entire 7 months, 21/42 (50.0%) were either scheduled in cardiac rehabilitation at MGH or referred to another cardiac rehabilitation program. 9/42 (21.4%) refused cardiac rehabilitation, 9/24 (21.4%) are still in process, and 2/42 (4.8%) were excluded for medical reasons.
Conclusions: Introduction of an electronic referral system in the provider order entry system increased the proportion of cardiac rehabilitation referrals from inpatients. This type of innovation may lead to more prompt access and better outpatient care after discharge.
Author Disclosures: J.H. Wasfy: None. K.C. Traynor: None. C. Brown: None. M. Leavitt: None. C. Cierpial: None. S. Kathiresan: None. K. Rosenfield: B. Research Grant; Significant; Abbott Vascular, Bard Peripheral Vascular. F. Ownership Interest; Significant; Lumen Biomedical, Medical Simulation Corp, VIVA Physicians Assoc. G. Consultant/Advisory Board; Significant; Abbott Vascular, Angioguard, Boston Scientific, Complete Conference Manager, Harvard Clinical Research Institute.
- © 2014 by American Heart Association, Inc.