Recent Research Shows Event Notifications Deliver
There’s not much literature yet on the effects of today’s healthcare models or technology. One area that’s getting some banter, and has recently shown real merit, is event notifications. We know admissions, discharges and transfers are critical periods to manage. We know readmissions cost facilities and patients alike, both monetarily and non-monetarily. Now evidence is showing that event-based notifications help cut costs, improve care and allow for proactive management when patients are at their most vulnerable.
Looking back, a sentinel study published in 2009 highlighted the need for improvement in care transitions by shining the light on preventable readmissions.
One fifth of the Medicare beneficiaries studied returned to a hospital within 30 days.1 There was one striking feature – 50% of the readmitted patients had no follow-up outpatient visit post-discharge. If there had been subsequent care touch points, would the patient have gone back to the hospital?
Fast forward to 2014. Siloed care is the antithesis of healthcare in the post-ACA world. Care boundaries are being sought and discarded. Providers are now responsible for patients before, during and after visits. Readmission rates are a key criteria for reimbursement and quality metrics. And soon, as part of Meaningful Use Stage 3, event notifications for care transitions will be a requirement, not a value-add.
Study shows alerts cut costs, improve care and network retention
Anecdotal evidence supports the use of event-based notification systems to alert providers to admissions, discharges and transfers. Among the benefits: Patient engagement, compliance and flow are all enhanced. Time to treatment and time to intervention are decreased. Management of chronic diseases and at-risk patients is improved. Communication between patient and provider as well as among providers is improved. Patient flow is better and discharges are better coordinated.
A 2014 case study presented by the Agency for Healthcare Research and Quality shows there is real evidence behind such speculation. It also highlights the benefit of layering the data exchange possibilities of existing HIE technology with near real-time alerts. In the study, a large HIE that connects more than 90 facilities used alerts for admits, discharges and transfers for two targeted patient populations – health plan members and individuals assigned to the Medicare ACO. The alerts contained patient’s name, chief complaint, hospital visited, attending physician’s name and preliminary diagnosis.
The health plans and ACOs that received alerts used the information to reach out to patients to educate them on the benefits of staying within the network as well as visiting a primary care physician instead of the ED for non-emergent cases. Many organizations used case managers to offer more personalized care to frequent ED users, to assist in scheduling and accessing follow-up care or to aid in patient compliance to medication, diets and self-management.
The result? Costs, utilization went down; quality went up. The managed health plan reduced non-urgent ED visits by 53% and increased lower-cost primary care visits by 68%. That shift saved an estimated $2-4 million over the six-month study period.
Event-based notifications play an integral part of ongoing care management and managing care transitions. Now we have evidence.
1 S. F. Jencks, M. V. Williams, and E. A. Coleman, “Rehospitalizations Among Patients in the Medicare Fee-for-Service Program,” NEJM, April 2, 2009 360(14):1418–28.
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