Clinical event notification (CEN) services are "a logical next step" to unlocking the potential of health information exchanges to improve care coordination, according to a study from the Icahn School of Medicine at Mount Sinai.
The paper, published at eGEMs, highlights the first year of a notification system to coordinate care for older patients in the emergency department.
"[W]e believe that widespread use of CEN systems has potential to reduce potentially avoidable admissions and duplicate testing, likely leading to decreased costs," the authors wrote. Although the study is focused on the elderly, they say the concept could be effectively used for other population groups.
The system, called GEDI WISE, was funded through a $12.7 million innovations award from the Center for Medicare & Medicaid Services. It incorporates patient data in the New York regional Healthix HIE, but also provides near-real-time notifications to providers when member patients go to emergency departments, even those outside its system.
When a patient goes to the ED, their primary care physicians are alerted in multiple ways, including through their EHR "in-baskets," email and text messages.
The patient data is available to those EDs through a Web-based clinical portal, but also through the service primary care physicians or care managers can contact the ED physician to provide additional clinical information and assist with arranging outpatient follow-up if the patient is discharged.
The researchers found patient stays of less than 48 hours is an area most likely to yield better targeted interventions to prevent potentially avoidable admissions and to reduce costs.
By using care coordinators who oversee patient scheduling from admission to discharge, a Chicago-area community hospital was able to improve patient flow and reduce average length of stay from 4.2 days to 3.93 days.
CMS recently announced it will pay physicians a monthly fee to coordinate care for Medicare beneficiaries with two or more chronic conditions--an often time-consuming process that traditionally has not been compensated.
To learn more:
- read the research