- A statewide health information exchange (HIE) program in Rhode Island is helping to coordinate care and improve population health management through real-time admission, discharge, and transfer (ADT) alerts and prescription drug monitoring messaging.
The alerts, which are available to participating providers within ten minutes of a hospital-related event, is actively helping to reduce costs and improve care management across the state, said Darlene Morris, Senior Director of Development and Grants at the Rhode Island Quality Institute (RIQI), during a presentation at the annual AHIMA Convention and Exhibit in Miami this week.
“More than 500,000 patients – half of the state’s population – have enrolled in CurrentCare, and access to the CurrentCare system and Care Management Alerts and Dashboard is available to all healthcare providers throughout the state,” said Morris in a press release emailed to journalists.
The Care Management Alert and Dashboard system is not integrated directly into an electronic health record (EHR) system, but is accessible through an internet portal. The strategy reduces the need to perform technical integration work with a large number of individual EHR systems from different vendors.
Alerts are sent in a secure email message or displayed on the web portal in a dashboard that can be downloaded into a spreadsheet. Providers can access an individual’s longitudinal health record, demographics, and current location in addition to risk scores around comorbidities and likelihood of readmission.
The real-time messaging capability has produced impactful financial and clinical results, Morris noted.
Hospital readmissions have decreased by 19 percent and repeat ED admissions have dropped by 16 percent, she said. In conjunction with a reduction in duplicate imaging testing, the drop in utilization has helped the state save $13.3 million.
In addition to saving money, the HIE network is shaving hours of manual work from providers’ daily schedules. The majority of care teams used to spend between 6 and 11 hours identifying high-risk individuals.
After gaining access to the alert dashboard, a quarter of care teams spend 5 or fewer hours on risk stratification, and none spend more than 10 hours.
“We’ve also been told by providers that timely follow-up care leads to improved outcomes and improved communication with patients that strengthen the patient-provider relationship. Some patients have reported that their doctors’ offices called them after discharge from the hospital before they even arrived back home,” Morris said.
Patients who participate in the real-time alerting service can also select a family member or caregiver to receive alerts, Morris added.
“This notification service can be especially valuable if loved ones of patients suffering from opioid use disorder or other mental health conditions are involved early on,” she said.
Monitoring prescription drug data and controlling the improper use of opioids is a primary goal for Rhode Island healthcare providers, who are leveraging the state’s prescription drug management program (PDMP) in addition to the real-time alerts to inform clinicians about patient behavior patterns.
In 2017, the state created a pilot program with Rhode Island’s largest integrated delivery network to gain more visibility into opioid use and potential misuse of prescription drugs. Rhode Island ranks seventh in the nation for fatal overdoses.
“We integrated the PDMP into the system’s EHR and implemented Care Management Alerts and Dashboards in six opioid treatment programs, which includes 14 sites and more than 5,000 clients with opioid use disorder,” Morris explained.
Adding the data into the EHR workflow reduced burdens on providers and increased their ability to proactively address issues and engage with the data in the PDMP.
The ADT alerts also help providers track substance abuse patients who may be lost to treatment.
“For example, in substance abuse treatment programs, patients sometimes stop coming. Providers will get an alert if the patient has been admitted to a hospital or emergency department,” Morris said.
The RIQI’s efforts to improve access to critical patient data illustrates the importance of leveraging analytics and health information management strategies for population health management and care coordination, said AHIMA CEO Wylecia Wiggs Harris, PhD, CAE.
“The CurrentCare initiative is one example of the innovative contributions made by health information management (HIM) professionals to improve the quality and continuity of care,” said Wiggs Harris
“When providers have easy access to a complete view of their patients’ health records and history, and near real-time updates in patient status, they can respond quickly in situations that require timely intervention.”