3M, the maker of the Potentially Preventable Readmissions (PPRs) software, responded to recent criticism that it fails at distinguishing differences in care quality by submitting a letter to BMJ Quality and Safety, which published the study. The following are excerpts from the letter:
- “Given that the study design examined the rate of quality problems for patients with PPRs compared to patients with non-PPRs, no meaningful conclusion can be drawn from the study results. The correct study design would have been to examine the rate of quality problems for pneumonia patients with a readmission categorized as a PPR compared to pneumonia patients who were not readmitted. There is a reasonable expectation that pneumonia patients who were not readmitted would have fewer quality problems than pneumonia patients with a readmission categorized as a PPR.”
- “In order to be consistent with the definition of PPRs and the intended use of PPRs, the most meaningful study design would have examined the rate of quality problems for pneumonia patients with a PPR who were treated in hospitals with a high risk-adjusted PPR rate compared to pneumonia patients who were not readmitted.”
- “Judgment on the ultimate efficacy and utility of PPRs should be based on whether PPRs identify patients for whom quality improvement is realistically possible and whether PPR-based data can be used to actually achieve lower readmission rates. For example, between 2011 and 2013 the PPR-based “Reducing Avoidable Readmissions Effectively” (RARE) Program in Minnesota reduced readmissions by over 20 percent by preventing 7,975 readmissions, thus avoiding more than 31,900 bed days. (MHA, 2015) Such reductions demonstrate that PPR-based data is effective in fostering real behavior change that leads to lower readmission rates.”