Assigning patient risk levels in two steps

Identifying which of your patients are at highest risk of an adverse clinical outcome is the first step to preventing those health problems. Your practice can accomplish this using a two-step process.

Step one: Sort patients into three risk categories: high, medium, and low based on objective factors such as chronic conditions, advanced age, and multiple comorbidities. Some EHRs can do this for you.

Step two: Separate patients in each of those three categories into two more categories based on how staff and physicians answer the following, more subjective, questions:

• Low risk: Is the patient healthy with no medical problems and in-range biometrics? Or is the patient healthy with no medical problems but with out-of-range biometrics?
• Medium risk: Does the patient have chronic conditions that are well managed? Or does the patient have chronic conditions that are out of control but without complications?
• High risk: Does the patient have complications of chronic disease or high-risk social determinants of health? Or is the patient potentially in danger of dying or being institutionalized within the next year?

By the end of the process, all patients can be sorted into six levels of risk, ranging from “healthy with no medical problems and in-range biometrics” in Level 1 to “potentially in danger of dying or being institutionalized within the next year” in Level 6. Your practice can use this information to make decisions such as which patients should be first to be offered a flu shot or which patients may require additional outreach or in-office time.

Read the full FPM article: “Risk Stratification: A Two-Step Process for Identifying Your Sickest Patients.”