event notification service

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Event Notification Service A Service of the Florida Health Information Exchange Presented by Milly Hardin May 20, 2014

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Event Notification Service. A Service of the Florida Health Information Exchange Presented by Milly Hardin May 20, 2014. Hospital Trends. There were 8,479,256 emergency department (ED) visits in Florida in 2011 28% Medicaid 23% Medicare 22% Commercial 19% Self-pay 8% Other. - PowerPoint PPT Presentation

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Page 1: Event Notification Service

Event Notification Service

A Service of the Florida Health Information Exchange

Presented by Milly HardinMay 20, 2014

Page 2: Event Notification Service

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Hospital Trends• There were 8,479,256 emergency

department (ED) visits in Florida in 2011– 28% Medicaid– 23% Medicare– 22% Commercial– 19% Self-pay– 8% Other

Page 3: Event Notification Service

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Hospital Admissions• Almost 19% of all ED visits resulted

in hospital admission– 1,599,511 total hospital admissions– 250,138 admits (15.6%) were Medicaid

patients• 200,399 adults (80%)• 49,739 children (20%)

Page 4: Event Notification Service

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Non-Urgent ED Use• Over 50% of ED visits in FL in 2011

were potentially avoidable through treatment in a primary care setting– 4.2M ED visits could have been avoided– $10.6B in services could have been

delivered by a primary care provider (PCP)

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The Opportunity• Finding a reliable way to reduce non-urgent

ED use can significantly decrease the costs of providing care– PCP visits cost less than ED visits for non-urgent

care– PCP visits provide routine and preventative care

• Health plans could promote better utilization of health care resources if they had timely notice of member hospital encounters

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An Example• A hospital alert pilot in Indiana

provided notice of hospital encounters to health plans– Alerts used to identify cases of

non-urgent ED use• These members were given

information about the plan’s 24-hour nurse line

• Encouraged to contact their PCP for questions and follow-up care

• Frequent ED users provided with more personalized support

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An Example• Indiana pilot results– Reduced non-urgent ED use

by 53%– Increased PCP office visits by

68%– Less fragmented patient care– Reduced the cost of providing

care by an estimated $2M - $4M over the six month pilot

Page 8: Event Notification Service

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Event Notification Service• ENS allows Florida health plans to

receive timely notice of member hospital encounters– Health plans subscribe by

submitting a roster of current members

– Participating hospitals provide patient data to match against health plan rosters

– When a match is made, information from the patient’s hospital visit is sent to the health plan

Page 9: Event Notification Service

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Subscribing• Health plans subscribe by providing a

roster of current members (a panel) to the Florida HIE– Panel only uses information that

plans already have and use regularly

– Panels are updated frequently to reflect changes in patient relationships

– Panels can include both commercial and Medicaid enrollees

– Panel can consist of all plan members or a subset

Page 10: Event Notification Service

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Hospital Data• Participating hospitals provide the

Florida HIE with copies of their ADT feeds – ADT = Admit, Discharge, Transfer

– Feeds include information that identifies the patient and the reason for the hospital visit

– Pilot participant Broward Health System sees over 250,000 patients/year

– Additional hospital data sources will be joining throughout 2014

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Receiving Alerts• Once a match is made between the

ADT feeds provided by the hospitals and the “subscribed to” panel provided by the health plan:– Alerts are packaged and

delivered via• Direct Secure Messaging (DSM) or• Secure File Transfer Protocol (SFTP)

– Alerts can be delivered as available or batch delivered daily or weekly

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ENS Alerts• Content of ENS alerts

Source Facility DOB Event Time & Date

Source Class (ED/Inpatient) Address Hospital Name

Name Home/Cell/Work Phone Hospital MRN

Gender Event (Admit/Discharge) Primary Complaint

Page 13: Event Notification Service

Sample Alert: As Available

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Sample Alert: Daily Batch

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Event Notification Service

– Facilitates better care coordination and case management

– Can be used to proactively prevent unnecessary hospital readmissions

• Provides up-to-date contact information

• Delivers timely, actionable information on members’ hospital encounters

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Florida HIE

• Contact the Florida Health Information Exchange– www.florida-hie.net– [email protected]– 850-412-3766