In order to improve health care quality in a meaningful way, physicians must be empowered to make informed clinical decisions. This includes being promptly notified of changes to a patient’s health status and any new “care events.” A care event could include the patient receiving care from a specialist, being seen in an emergency department or admitted to a hospital and then discharged to home or to another facility.
While greater interoperability between systems is driving more information exchange than ever before, this approach is only one step in improving health outcomes. Using the latest technology to turn information into actionable data that is helpful at the point of care is essential. Delivering information through event-based notifications that are furnished to providers across a community of care is essential for improving quality, satisfaction and reducing cost.
Delivering real-time information to improve care transitions
Event-based notifications are real-time notices that inform providers whenever a patient experiences a given care event. Ideally, these notifications should be configurable to align with the population health goals of an organization. For example, notifications could inform all primary care physicians (PCPs) or case managers that a patient in a specific high-risk group is admitted to the hospital.
Timely event-based notifications are critical for improving processes and care delivery at the transition of care. For example, if a patient with congestive heart failure is admitted and then discharged from a hospital, a PCP could be notified promptly upon that patient’s discharge. As a result, the physician’s office can reach out to the patient to schedule follow-up care within a matter of hours. Care managers could also be notified when the individual is admitted, allowing them to monitor care during the course of the hospital stay and coordinate with multiple providers when the patient is discharged. To illustrate the power of this approach, compare that to the process and time associated with faxing, receiving and managing traditional discharge summaries. It can take days for a fax to be sent to the practice and then acted upon, particularly if the patient is discharged on a Friday. This delay can have a negative impact on outcomes given the high rates of readmission for chronically ill patients who don’t receive timely follow-up.
Applying best practices to move from information into action
The successful use of event-based notifications is driven by a variety of factors. First and foremost, these notifications should be integrated into an organization’s specific strategies for improving quality. That might include programs designed to improve care transitions or reduce the average length of hospital stays. It is also critical that the organization sets up goals and a consistent, evidence-based plan of action once notifications are received. This will allow for the optimal use of resources and the appropriate intervention for a given scenario. For instance, an organization may want care managers to respond to discharge alerts within 24 hours by contacting patients to enroll them in a care management program.
Delivery frequency should also be defined by the user to prevent provider alert fatigue. This ensures that providers determine the most time-sensitive, high-risk scenarios to be notified about. They may determine that for high-risk patients, individual notifications are sent in real-time and then for lower-risk groups, a summary report can be made available for review. Providers should also be able to define their preferred delivery method. This could include receiving alerts via secure email, text or directly within an Electronic Health Record. As a result, providers can use notifications in the way that best complements their existing workflow.
Lastly, and perhaps most importantly, the information used for notifications must be robust and complete. That’s why a platform of health information exchange is often developed first to ensure that data is flowing freely across a network; then the capabilities for event-based notifications can be effectively “layered” on top of this platform.
Evolving with industry shifts and innovations
Event-based notifications not only help drive greater quality, they can also help organizations comply with existing and new requirements and enhance reimbursement opportunities. For example, CMS requirements (CMS A-0133) state that patients have the right to have a family member and/or physician promptly notified if they are admitted to a hospital. These notifications can also be useful from a payment perspective with the recent addition of new current procedural terminology (CPT) codes designed to capture transitions of care.
Event-based technology is sure to evolve as organizations explore new applications for its use. While today most notifications focus on care events, there are also other ways that they can empower providers and engage patients. For example, alerts could be sent if a patient does not refill a critical prescription on time, or a provider and his or her patient might be notified when an annual checkup is past due.
With event-based notifications, organizations deliver essential information to the right hands at the right time to support care coordination and patient outcomes. Given new value-based reimbursement opportunities with transitions of care and penalties for readmissions, this approach also can have substantial financial advantages for health care organizations.
David Palkoner is vice president, product management at Medicity.