SHM Converge Scientific Abstract ePoster Gallery-Using a Bpa to Address Practitioners Impatience With Inpatients

Pdf Summary

This document describes a quality-improvement study on using an electronic medical record (EMR) Best Practice Advisory (BPA) to improve communication and accuracy in inpatient vs. observation status decisions. The authors note that hospital reimbursement, compliance, and patient flow depend on timely and correct status orders, but these decisions are often delayed because practitioners rely on utilization review teams and complex medical-necessity rules.<br /><br />To address this, the team built an EMR-based workflow in which case managers and physician advisors entered concurrent review recommendations into a form. The EMR compared those recommendations with the patient’s current status and fired a BPA when there was a mismatch. This alert allowed the treatment team to quickly review and accept recommendations, reducing extra steps and minimizing disruption to clinical workflow.<br /><br />Results showed strong engagement: providers responded to BPA recommendations in 68% of cases, which was much higher than the 20–30% response rates often seen with other BPAs. The intervention also improved operational outcomes. Among managed Medicare patients, the proportion remaining in observation status for more than 48 hours decreased significantly in one analysis, and inpatient discharges increased from 48.9% to 52.5% post-intervention. Another observation metric also trended downward.<br /><br />Overall, the study found that an EMR-based BPA improved communication efficiency, increased practitioner participation, reduced prolonged observation stays, and supported more appropriate inpatient admissions. The authors conclude that this approach could be scaled to other healthcare settings to improve hospital workflow, and that further optimization may broaden its usefulness in other clinical processes.

Asset Subtitle

Vidushi Golla

Meta Tag

Author List Monal Shah, Stephen J. Harder, Vidushi Golla

Category Research

Concept Inpatient Status

Concept Observation Status

Concept Epic EMR

Concept Best Practice Advisory

Concept Status Determination

Distinguished Non-Finalist

Presenter Organization UT Southwestern

Presenting Author Vidushi Golla

Track Communication

Keywords

electronic medical record

best practice advisory

inpatient status

observation status

quality improvement

utilization review

hospital reimbursement

clinical workflow

patient flow

medical necessity

Inpatient Status

Observation Status

Epic EMR

Best Practice Advisory

Status Determination