IllumiCare Report Finds More Providers Result in Longer Hospital Length of Stay (Interview)


When a hospitalized patient is engaged by more than three actively involved providers, the patient’s length of say (LOS) increases by a little over half a day for each additional provider. The correlation exists even when risk-adjusting with disease-related groups (DRGs) and it’s agnostic to the type of additional provider and whether those providers represented one or many different specialties. These are just some of the findings highlighted by Another Doc, Another Day, a recent report published by IllumiCare, an EMR app development company based in Birmingham, Alabama. With an average cost per hospital day of $2,424, additional LOS can increase cost as well as the risk of hospital-acquired infections.

Source: Another Day, Another Doc by IllumiCare (Figure 1)

The report highlights a “too many cooks in the kitchen” issue where more doctors does not necessarily result in more efficient care, in part due to inefficient information transfer between providers. Considering the degree to which some providers consult with peers, the report found that hospitalists consult with an average of 4.29 providers per case, though the range varied from 1.3 to 11.84 FOR other specialists across data from 280 admissions.

Source: Another Day, Another Doc by IllumiCare (Figure 3)

According to G.T. LaBorde, CEO of IllumiCare, “Since medicine is not formulaic, it is difficult to manage each provider’s practice habits and tendencies, like the habit of consulting. Our goal is to shed more light on various provider habits that not only increase the cost of care, but also risks to the patient, and help executives and care teams be more judicious.” Medgadget had a chance to follow up with G.T. to learn more about the report.

Medgadget: How did IllumiCare capture the dataset on which the report was generated?

G.T. LaBorde:  We capture clinical and financial data in real-time from client hospitals as a part of providing services to them. Part of those services is helping them understand clinical variation and ways of being more efficient.

Medgadget: Did you glean any insights into whether the inclusion of certain specialties was more likely to result in longer LOS?

LaBorde:  This analysis did not look at each subspeciality individually and in combination with others; only hospitalists and then every other specialty were considered as a group. Given that there are a number of subspecialties in medicine, there’s a large number of permutations (e.g., Patient 1: a hospitalist and a GI doc; Patient 2: hospitalist, neurology, infectious disease).

Medgadget: How does the report create a distinction between necessary and excessive LOS? 

LaBorde: The idea is to group equivalent patients such that within each DRG cost and length of stay are similar. So, to find one variable that is so tightly correlated to incremental increases in length of stay within a DRG, that is generally true across all DRGs, is noteworthy.

Medgadget: What is the risk of excessive LOS?

LaBorde: Every day in the hospital brings the risk of infection or other complications. So, the more efficient we can be at taking care of patients, the better it is for patients.   

Medgadget: How can providers leverage the insights of this report? Does IllumiCare’s Smart Ribbon play a role in helping reduce unnecessary LOS?

LaBorde: We are working with customers to identify “over-consulting.” Now that we know the effect of each additional provider, we can look at handoffs between providers and consultation practice to see if any improvements can be made.

Report: Another Doc, Another Day

Link: IllumiCare homepage

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