Intermountain Healthcare is an internationally recognized, integrated, not-for-profit health system based in Salt Lake City, Utah, (USA) with 33 Hospitals, (includes ‘virtual’ hospital), 385 Ambulatory Care Centers (clinics), approximately3,900 employed physicians and advanced practice providers, and a health insurance company, Select Health, which covers more than 1.2 million lives. Intermountain is widely recognized as one of the premier healthcare systems in the United States and as a leader in transforming healthcare through high-quality clinical outcomes and efficient healthcare delivery at a sustainable cost.
Heart failure is well known to be a complex clinical syndrome associated with significant morbidity and mortality. It has been the leading cause for hospital admissions in the Medicare population and is associated with significant hospital readmissions, significant comorbidities and poor quality of life. As a result of the 2012 Center for Medicare and Medicaid Services (CMS) and the Hospital Readmission Reduction Program and resulting penalties for excessive readmissions, the Cardiovascular Clinical Program has actively supported system-wide strategies to improve 30-day outcomes for patients admitted with a diagnosis of heart failure (HF) for years. The goal has been to reduce readmission rates and improve mortality for heart failure patients. Early work showed that outcomes improved with coordinated team efforts to provide evidence-based medications to patients with heart failure at the time of hospital discharge. Aiming for a large-scale system initiative, creating computerized decision support logic to identify patients who have the highest risk for poor outcomes was the goal.
In the full version of this case study, Intermountain Healthcare shares the implementation overview and the key participants who were involved in the process.
The results: High risk patients identified during a HF hospitalization had 21% lower 30 day readmission compared to high risk controls and 52% lower 30-day mortality. Results of the work were published in the American Heart Journal.
One sentence that encapsulates the experience as a whole: “A risk score guided having dedicated teams to create a validated identification and risk report used at the point of care by a multidisciplinary team can lead to improved outcomes for patients with heart failure.”