READMISSION RISK ASSESMENT

• US 20120046965A1
• Filed: 10/28/2011
• Published: 02/23/2012
• Est. Priority Date: 06/17/2010
• Status: Active Grant

• Current Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Original Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Inventors: RUOFF, CHAD BARRETT, RYAN, HUGH H., AZZARO, FRANK A., BAKER, PAMELA M., CAPPO, DONNA J.
• Granted Patent: US 8,694,334 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Readmission risk of patients admitted to a healthcare facility are determined using a generic readmission risk algorithm. The readmission risk assessment of patients may be based on portions of a patient'"'"'s profile and may be performed before, during, and after their index admission. Based on the readmission risk assessment of patients, those patients that are at a greater risk for readmission may be identified. A readmission prevention worklist may be provide that identifies those patients and facilitates managing the risk of readmission for those patients.

Claims

1. One or more computer storage media storing computer-useable instructions that, when used by one or more computing devices, cause the one or more computing devices to perform a method, the method comprising:

applying a readmission risk algorithm for each patient admitted to a healthcare facility;

responsive to applying the readmission risk algorithm to each patient admitted to the healthcare facility, identifying a subset of patients at risk for readmission;

generating a user interface to manage the subset of patients at risk for readmission; and

providing the user interface for presentation to a clinician.

2. The one or more computer storage media of claim 1, wherein the readmission risk algorithm determines whether a patient is at risk for readmission based in part on the patient'"'"'s length of stay satisfying a threshold length of stay.

3. The one or more computer storage media of claim 1, wherein the readmission risk algorithm determines whether a patient is at risk for readmission based in part on a combination of the patient'"'"'s age and social isolation of the patient.

4. The one or more computer storage media of claim 1, wherein the readmission risk algorithm provides an indication for each patient as either a high risk for readmission or a low risk for readmission, and wherein the subset of patients at risk for readmission comprises patients determined as a high risk for readmission.

5. The one or more computer storage media of claim 1, wherein the method further comprises suggesting a readmission prevention plan of care for each patient within the subset of patients at risk for readmission.

6. The one or more computer storage media of claim 1, wherein the method further comprises identifying, for a first patient within the subset of patients at risk for readmission, one or more readmission risk factors for the first patient based on one or more algorithm criteria met for the first patient to cause the first patient to be determined to be at risk for readmission;

and providing an indication of the one or more readmission risk factors within the user interface.

7. The one or more computer storage media of claim 1, wherein the readmission risk algorithm is applied for each patient at a time of admission of each patient.

8. The one or more computer storage media of claim 1, wherein the readmission risk algorithm is applied while each patient is admitted at the healthcare facility.

9. The one or more computer storage media of claim 1, wherein the readmission risk algorithm is applied prior to discharging each patient from the healthcare facility.

10. The one or more computer storage media of claim 1, wherein the readmission risk algorithm is applied after discharging each patient from the healthcare facility.

11. One or more computer storage media storing computer-useable instructions that, when used by one or more computing devices, cause the one or more computing devices to perform a method, the method comprising:

accessing patient information for a patient at a healthcare facility;

determining a risk for readmission for the patient based on the patient information and a readmission risk algorithm that is generic to patients admitted by the healthcare facility;

identifying the patient as being at risk for readmission based on the patient information and the readmission risk algorithm;

adding the patient to a subset of patients identified as being at risk for readmission; and

providing a user interface for presentation that identifies at least a portion of the subset of patients identified as being at risk for readmission.

12. The one or more computer storage media of claim 11, wherein the readmission risk algorithm determines that the patient is at risk for readmission based in part on the patient'"'"'s length of stay exceeding a threshold length of stay.

13. The one or more computer storage media of claim 11, wherein the readmission risk algorithm determines whether that the patient is at risk for readmission based in part on a combination of the patient'"'"'s age and social isolation of the patient.

14. The one or more computer storage media of claim 11, wherein the method further comprises suggesting a readmission prevention plan of care for the patient based on identifying the patient as being at risk for readmission.

15. The one or more computer storage media of claim 11, wherein the method further comprises identifying one or more readmission risk factors for the patient based on one or more algorithm criteria met for the patient to cause the patient to be determined to be at risk for readmission;

and providing an indication of the one or more readmission risk factors within the user interface.

16. The one or more computer storage media of claim 11, wherein the readmission risk algorithm is applied for the patient at a time selected from the following:

a time of admission of the patient;

while the patient is admitted at the healthcare facility;

prior to discharging each patient from the healthcare facility; and

after discharging each patient from the healthcare facility.

17. One or more computer storage media storing computer-useable instructions that, when used by one or more computing devices, cause the one or more computing devices to perform a method, the method comprising:

accessing patient information for a first patient admitted or planned to be admitted to a healthcare facility;

determining, based on the patient information, if each of a first set of risk factors is satisfied, the first set of risk factors including;

(1) the first patient is being admitted within 30 days from a previous admission,

(2) the first patient is diagnosed with one of a plurality of predetermined conditions,

(3) the first patient'"'"'s age is above a threshold age and the patient lives in social isolation, and

(4) the first patient has a length of stay at the healthcare facility greater than a threshold length of stay;

determining, based on the patient information, if each of a second set of risk factors is satisfied, the second set of risk factors including;

(1) a number of emergency department visits for the first patient over a given time period exceeds a threshold number of emergency department visits,

(2) a number of admissions for the first patient over a given time period exceeds a threshold number of admissions,

(3) a comorbidity score for the first patient exceeds a comorbidity score threshold,

(4) the first patient has a predetermined type of insurance, and

(5) the first patient is being admitted to the intensive care unit;

identifying the first patient as being at risk for readmission based on at least one risk factor from the first set of risk factors being satisfied or based on at least two risk factors from the second set of risk factors being satisfied; and

providing a user interface for presentation that facilitates managing a plurality of patients identified as being at risk for readmission, the plurality of patients including the first patient.

18. The one or more computer storage media of claim 17, wherein the method further comprises suggesting a readmission prevention plan of care for the first patient based on identifying the patient as being at risk for readmission.

19. The one or more computer storage media of claim 17, wherein the user interface provides an indication regarding one or more risk factors causing the first patient to be identified as being at risk for readmission.

20. The one or more computer storage media of claim 17, wherein the first patient as identified as being at risk for readmission at a time selected from the following:

a time of admission of the patient;

while the patient is admitted at the healthcare facility;

prior to discharging each patient from the healthcare facility; and

after discharging each patient from the healthcare facility.