Health information exchange (HIE), such as sharing a patient’s medical information for the purposes of care coordination, is a critical success factor in achieving the quality improvement and efficiency objectives of the Affordable Care Act (ACA) and the HITECH Act. Thus, the Department of Health and Human Services (HHS) has a strong policy interest in rapidly driving broad participation in secure health information exchange. To address this need, the Office of the National Coordinator for Health IT (ONC) proposes to develop targeted, open source toolkits that can be rapidly and cost-effectively deployed by a wide range of health care entities including those that are not eligible for the Centers for Medicare & Medicaid Services (CMS) electronic health record (EHR) incentive programs (e.g. long-term care centers, skilled nursing facilities, surgery centers, home health agencies, imaging centers, public health departments).
The HHS Entrepreneur will work with the community of implementers to develop a standards based HIE platform built entirely from open source components. The platform aims to disrupt the economics of directed HIE by demonstrated how standards based exchange leads to scalability and how open source components allow for inexpensive setup.
The platform will be piloted by a group of Accountable Care Organizations that have risk-based incentives to improve care efficiency across federate boundaries. The initial use case will be sending “ADT Alerts”. An “ADT alert” is a real-time notification of an admission, discharge, or transfer encounter sent to a care coordinator or primary care physician (PCP) that is used to effectively intervene in the care pathway. Organizations using ADT alerts have shown reduction 30-day readmissions, improved outcomes and qualifying the PCP for higher Medicare reimbursements under the transitional care management CPT codes. Other organizations have demonstrated that ADT alerts can be used to reduce the number of ED to inpatient transitions. Effective interventions include activities such as scheduling a follow-up appointment after discharge, ensuring the patient understands discharge instructions, calling the ED to direct a patient to a less expensive admission and several other meaningful opportunities to affect the care pathway.
Claudia Williams, Office of the National Coordinator for Health IT
Erica Galvez, Office of the National Coordinator for Health IT
Paul Tuten, Office of the National Coordinator for Health IT
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