Assessment of Outpatient Complications and Secondary Health Conditions in Traumatically Injured Children using a Health Information Exchange
*Teresa M Bell1, *Jodi Hackworth2, *Thomas Rouse1
1Indiana University, Indianapolis, IN;2Riley Hospital for Children, Indianapolis, IN
Background (issue):Obtaining follow-up assessments after hospitalization for injury is difficult because many patients receive outpatient follow-up care outside of trauma centers. The Indiana Network for Patient Care (INPC) is a regional health information exchange with both clinical and billing data. The objective of this study is to determine if the INPC can be used to evaluate complications in the outpatient setting and the development of secondary health conditions in pediatric trauma patients.
Methods: We analyzed 807 pediatric patient records contained in the INPC for two years following patients’ initial hospitalization for injury. We determined the percentage of patients with encounters contained in the INPC and classified them as inpatient, outpatient, or emergency department visits. Next, we reviewed all provider notes for each encounter on a subsample of 40 patients. Notes were used to identify patients who developed complications and/or secondary conditions related to their injury.
Findings:We were able to match all 807 patients to at least one follow-up encounter in either the inpatient, outpatient, or emergency department setting. In the subsample analysis, we identified a total of 1,832 notes in the INPC for these 40 patients and determined 249 encounters were related to routine injury follow-up care, 20 were identified as episodes of unplanned care related to the injury, 10 patients experienced possible complications, and 16 had possible secondary conditions caused by the injury.
Conclusions (implications for practice):Our findings suggest that health information exchanges are useful in determining whether traumatically injured children experience outpatient complications or secondary health conditions after discharge.
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