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Real-Time Communication Tool for Improved Patient Care

This article highlights the need for a real-time communication tool in healthcare to provide timely patient information, including demographics, insurance details, and care manager contacts. It discusses the benefits of such a system, the challenges faced in implementing it, and provides a live demonstration.

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Real-Time Communication Tool for Improved Patient Care

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  1. Turning Best Practice intoCommon PracticeConnecting Michigan for HealthLansing, MIJune 8, 2017Ewa Matuszewski

  2. Daily Census Report • One fax from each health plan • No consistency of when information received • Significant delay in sharing admission and discharge information • No information ED visits, DME, Home Health • Limited information on skilled nursing facility and post acute care facility admissions, discharges and transfers

  3. Ideal State: A Communication Tool • Provide patient information in real-time “quo vadis” • Patient information • Demographics • Insurance • PO affiliation • PCP attribution • Care manager’s contact information • Patient specific instructions such as re-directing and “note sharing”

  4. Information About ADTs Spreads • “The ADT service is an important piece of improving patient care because provides primary care doctors and their care teams a single access point to timely information regardless of health plan affiliation, where the admission or ED visit occurred.” • Incentives to engage provided by BCBSM Tom Simmer, MD BCBSM Value Partnership

  5. Researching ADTs… • American corporation that provides residential and small business electronic security, fire protection and other related alarm monitoring services, 24 hours a day, 365 days a year • Androgen Deprivation Therapy • Average Daily Traffic Count • Associates Degree for Transfer • Advanced Dvorak Technique • Admissions, Discharges, Transfers

  6. Standards Available • There are 51 different types of ADT messages that are used for various trigger events • ADT-A01 – patient admit • ADT-A02 – patient transfer • ADT-A03 – patient discharge • ADT-A04 – patient registration • ADT-A05 – patient pre-admission • ADT-A08 – patient information update • ADT-A11 – cancel patient admit • ADT-A12 – cancel patient transfer • ADT-A13 – cancel patient discharge

  7. What and Who We Didn’t Know • In 2014 researched vendors engaged in ADT activity • MiHIN and Qualified Organizations (QO) • ACRS • Entered into an agreement with PatientPing • Tool was officially launched November 2014

  8. Ideal System • A healthcare provider would always receive real-time information • when a patient was admitted to a hospital, skilled nursing facility or post acute care facility • when a patient was seen in the ED • when a patient was receiving home care services or durable medical supplies

  9. Real-Time Notifications Are Important • Make the system more efficient • Help avoid unnecessary procedures, readmissions, and ED use • Monitor patients that are treated in facilities with which the healthcare professional has no relationship • Reinforce a team-based approach to health care

  10. Biggest Challenges • Normalizing the data: health systems • Translating data into a format that can be used • Revising workflow to support usability of alerts • Training alert recipients on appropriate routing and follow-up • Evaluating and reporting results for real time improvement

  11. Patient Roster CCD available for encounter CCD available for previous encounters

  12. Where Is the Patient High utilizer flag – 3 ER events in past 60 days 3 5 High utilizer flag – 5 ER events in past 60 days 3

  13. On Admission: High Utilizer High utilizer alert shown on admission

  14. CCD List Set of CCDs available for patient

  15. CCD View

  16. Alert Frequency • Healthcare professionals can be overwhelmed by receiving too many alerts • ADT-based alerts may be one of many types of alerts in a clinical system: room change, diagnostic testing • End users: Create ADT-based alerts on an appropriate delivery schedule and take into account other alerting workflows

  17. How Did We Get Started… • Started small • Education and training

  18. Staffing for Success • Physician Organization • Medical Management Team: blend of medical assistants, RNs and a medical officer of the day • Clinician of the Day: all care managers are assigned a day to monitor the ADT feed and send “census” report to practice units without an assigned care manager • RN: offsite clinician who reviews PO daily census; tracks crucial information such as lengths of stay, place of stay; communicates outlier information to the medical officer of the day or the PCP; and interacts with SNFs, Home Care Agencies, DME

  19. What’s In It For Me? • Transition of Care Billing • 99495 (Moderate Complexity) • Average reimbursement: $142.96 • 99496 (High Complexity) • Average reimbursement: $231.11

  20. Live Demonstration

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