Summaries of Independent Scientist (K) Awards

Moore, Carlton

Institution: Mount Sinai School of Medicine of New York University (NYU), and University of North Carolina, Chapel Hill
Grant Title: Discharge Summary Availability and Discontinuity Errors
Grant Number:  K08 HS14020
Duration: 4 years (2006-2010)
Total Award: $505,000

Project Description: This project has four main aims:

1. Conduct a nationally representative survey of hospitals to identify the current systems used to communicate hospital discharge information and their perceived efficacy.
2. Perform a time series cohort study to measure and compare the frequency of discontinuity errors that occur after hospitalization before and after implementation of a Web-based system to disseminate discharge summaries to outpatients primary care physicians (PCPs).
3. Assess associations between discontinuity errors and adverse outcomes in this cohort.
4. Design and evaluate a randomized controlled trial to compare the effectiveness of an E-mail strategy versus a Web-based strategy of disseminating electronic hospital discharge summaries.

Career Goals: Dr. Moore is an Associate Professor in the Department of Medicine at the University of North Carolina School of Medicine.  Prior to this appointment in 2007, he was an Assistant Professor in the Department of Medicine at Mount Sinai School of Medicine in New York.  He received his M.D. from Cornell University Medical School and served his residency in Internal Medicine at Mount Sinai. Dr. Moore was also a Fellow in Medical Informatics at Mount Sinai.  The grantee would like to become an independent clinical health services researcher with a focus on medical informatics.

Progress to Date: Dr. Moore has conducted a retrospective cohort study of patients discharged from the medicine or geriatrics service of a large teaching hospital.  Each subject's inpatient medical record was reviewed to determine if the hospital physician recommended an outpatient work-up.  The outpatient medical records were reviewed to determine if the workups were completed.

Future Plans: The grantee will assess the necessity of the recommended outpatient work-ups to determine if the work-ups that were not completed were truly medical errors.  Then, an assessment will be made as to whether the work-up errors resulted in post-discharge adverse events.  The frequency of test follow-up errors and medication continuity errors will also be investigated.  A randomized controlled trial of electronic dissemination of discharge summaries to patients PCPs will be conducted to determine if there is a decrease in the frequency of work-up errors, test follow-up errors, medication continuity errors, and post-discharge adverse events.

Highlights and Specific Accomplishments:

• Robert Wood Johnson Foundation Minority Medical Faculty Development Award, 2003.
• Newman Research Award, 1999.

K-Generated Publications: None thus far.

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