• James F Graumlich, Nancy L Novotny, G Stephen Nace, Himangi Kaushal, Waleed Ibrahim-Ali, Shoba Theivanayagam, L William Scheibel, and Jean C Aldag.
• Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. jfg@uic.edu
• J Hosp Med. 2009 Sep 1;4(7):E11-9.

BackgroundOne of the causes of postdischarge adverse events is poor discharge communication between hospital-based physicians, patients, and outpatient physicians. The value of hospital discharge software to improve communication and clinically relevant outcomes is unknown.ObjectiveTo measure effects of a discharge software application of computerized physician order entry (CPOE).DesignCluster randomized controlled trial.SettingTertiary care, teaching hospital in central Illinois.PatientsA total of 631 inpatients discharged to home with high risk for readmission.InterventionSeventy internal medicine hospital physicians were randomly assigned (allocation concealed) to discharge software versus usual care, handwritten discharge.MeasurementsBlinded assessment of patient readmission, emergency department visit, and postdischarge adverse event.ResultsA total of 590 (94%) patients provided 6-month follow-up data. Generalized estimating equations gave intervention variable coefficients with 95% confidence interval (CI). When comparing patients assigned to discharge software versus usual care, there was no difference in hospital readmission within 6 months (37.0% versus 37.8%; coefficient -0.005 [95% CI, -0.074 to 0.065]; P = 0.894), emergency department visit within 6 months (35.4% versus 40.6%; coefficient -0.052 [95% CI, -0.115 to 0.011]; P = 0.108), or adverse event within 1 month (7.3% versus 7.3%; coefficient 0.003 [95% CI; -0.037 to 0.043]; P = 0.884).ConclusionsDischarge software with CPOE did not affect readmissions, emergency department visits, or adverse events after discharge. Future studies should assess other endpoints such as patient perceptions or physician perceptions to see if discharge software has value.Copyright 2009 Society of Hospital Medicine.

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