Abstract 187: Baseline 7 Day Follow Up Rates in Cardiology Patients: Impact of Electronic Medical Record-Based Appointment Order

Background: There has been intense focus on 7 day follow up in congestive heart failure patients, but this approach has not been emphasized in all cardiology patients. We measured baseline early follow up rates and implemented an electronic medical record (EMR)-based order to secure early follow up at discharge for all cardiology patients. Methods: We performed an analysis of 39,211 patient discharges from the cardiovascular medicine services within an academic center between 2012 and 2017. In the pre-implementation era, scheduling of follow up appointments was at the discretion of clinical team. The EMR-based order scheduled appointments at time of discharge. The order provided an option for a 7 day visit with a physician assistant and/or 30 day follow up with the physician. Follow up rates were monitored for six years; pre (2012-2013) and post-implementation (2014-2017) era rates were compared using chi square analysis. Results: The average age of the patient was 69.3 ± 14.7, 60.7% were male, 75.7% were white and 20.8% were black. In the pre-implementation era between 2012 and 2013, average rate of follow up at 7 days after discharge was 13.4% (1,723 of 12,854). In the post-implementation era, the average rate of follow up at 7 days after discharge increased to 19.8% (5,225 of 26,357, p < 0.0001). Conclusion: An EMR-based appointment order led to improvement of 7 day follow up rates. However, absolute rates of follow up remained low indicating the need for further refinements of the process and patient engagement to increase follow up rates.