The health-care landscape is changing.

Patients and insurance companies are demanding more value for their dollar. There is extra focus on high-cost patients and chronic disease management.

Clinicians and patients now have a better understanding of the relationship between interventions and positive patient outcomes.

The Patient Protection and Affordable Care Act, otherwise known as “Obamacare,” has brought technology closer to health-care consumers.

Some doctors now print out paperwork from the electronic health record for patients to take home and review. This printout is called an After Visit Summary, or AVS for short. An After Visit Summary is typically given to patients when they are being released from the care of a health-care provider from either a clinic appointment or a hospital admission.

Studies have shown that patients forget between 40 percent and 80 percent of the information they receive from their providers, and half of what they remember is inaccurate. The more information patients get, the harder it is to remember.

This can lead to medication errors and poor follow-through with care. Patients want information about their health. The more engaged they are, the more likely they are to follow the instructions and treatment plan. Combining written directions with verbal instructions increases a patient’s ability to follow recommended care. (U.S. Department of Veterans Affairs, 2015)

The After Visit Summary gives patients a written care plan they can follow. It is their point of reference when they have questions about what they learned in the hospital or during an office visit.

The information is personalized and is automatically updated from visit to visit as the information in a patient’s electronic medical record changes.

Hospitals and providers receive incentives for using electronic medical records in a meaningful way, and the AVS is one method to meet those requirements.

The Centers for Medicare and Medicaid Services has defined what needs to be included on a clinical summary, or After Visit Summary in order to meet the meaningful use requirements. Elements on an AVS include the name of the provider, a diagnosis, discharge instructions, a current list of medications and instructions on how to take them, laboratory or other ordered tests, and results. Other possible information includes the time and location of the next appointment. (EHR Incentive Program, 2014).

Typically, AVS information is presented to patients in a few concise pages that are clear and easy to read. The information on the AVS will vary depending on what type of medical encounter the patient experiences.

A stay at a hospital will result in a longer summary, while a doctor’s office visit will likely be shorter. With a few clicks of a mouse, health-care providers can attach additional information to the AVS, such as easy-to-read educational materials about a diagnosis.

The purpose of the After Visit Summary is to help patients remember information from an office or hospital visit. It helps them as they share this information with family members and loved ones. The AVS supports patients to make better health-care choices at home, as well as better manage their chronic conditions.

Having printed instructions provides a resource to refer to, especially when medical information is complex, or when health-care information or diseases are overwhelming. Discharge instructions provide patients with customized, actionable information for their health-care needs. Studies have shown the more patients understand their health and any illness they may have, the better health outcomes they experience. (Adams, 2010)

An AVS serves as a valuable reference for patients to understand the health care they receive. It gives them a road map to better health. The After Visit Summary gives patients more knowledge about the care they have received while empowering them to take a more active role in managing their health.


Carol Knieper, MSN, RN, is regional director of informatics, and Angela Reynolds, BS, LPN, is a clinical informatics specialist for Providence Western Montana Region.

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