Examining the impact of regular physician visits on heart failure patients: a use case with electronic health data

The rapid adoption of electronic health records (EHRs) presents opportunities to study care management within health systems. We examine the efficacy of using EHR data to assess the outcomes of outpatient care for chronic disease management. A retrospective-prospective study was conducted using 6 years of archived EHR data from patients treated for heart failure at a rural community hospital. Patients were placed into two cohorts, ‘Regular’ and ‘Non-Regular’, based on the frequency of provider contact. A hospital charge ratio was used to calculate cost. Patient mortality and the frequency of unintended events were used to assess patient outcomes. Case study results suggest that sporadic outpatient care was associated with greater utilization of more intensive health-care services. When inpatient and Emergency Department utilization became necessary for both groups, the Regular outpatient cohort had lower mortality rates, fewer readmissions, and incurred lower and less variable costs. Overall, the study showed great potential for using EHR data for assessing care outcomes, notwithstanding some key limitations. We conclude by discussing the types of insights possible and shortcomings attributed from health systems research derived from EHR data.