Abstract 186: Securing Cardiology Follow Up Appointments Through Sustained Utilization of Electronic Medical Record-Based Order

Background: The merits of creating follow up appointments at discharge are increasingly recognized, but interventions rarely translate to sustained improvements. We implemented an EMR-based appointment order to secure cardiology appointments prior to discharge and measured its long-term sustainability over four years. Methods: We performed an analysis of 26,358 patients discharged from the cardiology services within an academic center between 2014 and 2017. The electronic follow up order went live on January 1 st , 2014. Once the order was entered by a provider in the medical record system, it was routed to a scheduling pool. A scheduler created the appointment, text paged the provider with confirmation, and entered the information in the patient’s discharge paperwork. We analyzed order utilization for four years using Kendall Tau B analysis to understand the impact and sustainability of this process. Results: Average age of the patient was 68.7 years and 61% were male. In the 26,358 patient discharges, 18,068 discharges had a follow up order placed (69%). Between 2014 and 2017, order utilization steadily increased from 50% to 77% (p=0.01). In 2014, 3,216 of 6,446 discharges utilized the order (50%). In 2015, 4,795 of 6,651 discharges utilized the order (72%). In 2016, 4,981 of 6,643 discharges utilized the order (75%). In 2017, 5,079 out of 6,621 discharges utilized the order (77%). Conclusion: The EMR-based follow up order is a sustainable mechanism for securing cardiology follow up appointments after hospital discharge. Higher rate of appointments created could translate into meaningful improvement of outcomes and reduce readmissions.