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QR Codes Mature as a Useful Tool; Relevance for Post-Discharge Patient Education

Posted Aug 21 2012 12:00am

I was recently reading an article in the WSJ about problems with the Mississippi River due to the drought. Embedded in the article was a QR code . Grabbing an image of the QR code with my smart phone and running the Goggles app enabled me to quickly play a video about the issue that made it more vivid and understandable for me. The QR code served as an efficient way to append visual content to written content with little effort required. It seems to me that the value of QR codes is now becoming more apparent.

Continuing in this same vein, one of the most pressing problems for hospitals these days is the readmission of inpatients shortly after discharge. Payers are balking at reimbursing hospitals for these readmissions and fighting back with bundled payments. They won't reimburse for some hospitalizations if the patient is readmitted within, say, six months. Their claim is that some patients are being discharged prematurely in order to free up beds and that an effort should be taken to avoid such events.

As an oversimplification, many of these readmissions are patients with chronic diseases who relapse soon after hospital discharge. Some of these relapses are due to inadequate post-discharge outpatient surveillance, the failure of patients to take their prescribed drugs (see: Half of Heart Patients Don't Take Their Meds; Probably a System Related Cause ), or the failure of patients to correct lifestyle issues such as an inappropriate diet. Many of these problems could be ameliorated by better patient and family education prior to discharge. However, efforts directed toward patient education are often given short shrift or not dealt with at all. The period surrounding hospital discharge is the worst time for such activities because events are rushed and time is compressed.

Consider the following scenario by which hospitals could use QR codes to enhance patient education around the time of discharge:

  • A hospital acquires a library of professional videos and brochures pertaining to patient education on topics such as congestive heart failure, diabetes, healthy diet, colostomy care, or wound care.
  • At the time of hospital discharge, the discharging physician and nursing staff would create a check list of educational materials that would be useful for the patient to read/view in their home setting.
  • All of the relevant materials would then be queued up and loaded as a customized set on a server. At the head of the queue would be, say, a video of the patient's doctor who would greet the patient and emphasize the important nature of the educational materials to follow.
  • A card would be generated for each patient at the time of discharge with a QR code that would provide an immediate link to the customized stack of educational materials that had been queued up. To access the materials on a cell phone or computer at home, the patient would only need to scan the QR code with the smart phone or enter the set of numbers listed at the bottom of the QR code.
  • Embedded in the stack could also be a link to an on-line chat line with a hospital nurse educator if any questions arose. This is similar to the chat lines available on e-commerce web sites.

I am sure that such a patient education system could be established for a relatively low cost per discharged patient. Such a cost would be very small in comparison to the cost of readmissions if reimbursement is denied by payers. This cost also does not even take into consideration the mental and physical cost of such readmissions for the patients.

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