Impact of an Electronic Health Record (Ehr) Implementation on Hospital-Acquired Venous Thromboembolism (Vte) Rates and Appropriateness of Prophylaxis Therapy

PURPOSE: Hospital-acquired VTE is a very serious health complication for hospitalized patients leading to increased medical costs and death. VTE is preventable and therefore is not reimbursed by payers. The impact of an integrated EHR on VTE prophylaxis strategies and the incidence of hospital-acquired VTE is unknown. The purpose of this project is to determine the incidence of hospital-acquired VTE and assess the appropriateness of prophylaxis therapy provided pre- and post-implementation of an integrated EHR.

METHODS: Using data retrospectively collected from University HealthSystem Consortium (UHC), investigators compared incidence of hospital-acquired VTE as well as the appropriateness of pharmacologic and non-pharmacologic therapies provided for a time period of six months prior versus six months after implementation of an integrated EHR.

RESULTS: There were 158 cases of hospital-acquired VTE out of 13,685 patient discharges during the pre-EHR time period of July 1st, 2012 through December 31st, 2012. A total of 114 cases of hospital-acquired VTE out of 12,876 patient discharges during the post-EHR time period of July 1st, 2013 through December 31st, 2013 resulted in a statistically significant decline in the incidence of hospital-acquired VTE (p = 0.0294). Appropriateness of pharmacologic and non-pharmacologic prophylaxis therapy provided to sample groups (N = 75) of both populations, determined as the average length of stay (LOS) during which time appropriate risk-stratified prophylaxis was provided, was not significantly different (p = 0.9679). There was also no statistical difference in appropriateness of prophylaxis provided to sample groups (N = 75) of all discharged patients post-EHR and patients with confirmed VTE post-EHR (p = 0.2141).

CONCLUSIONS: Implementation of an integrated EHR may have a significant impact in reducing the rates of hospital-acquired VTE.