- HIE use of admission, discharge, and transfer (ADT) notifications grew by an impressive 95 percent among users of the Statewide Health Information Network (SHIN-NY) from 2016 to 2017, according to the New York eHealth Collaborative (NYeC).
NYeC published its findings based on research conducted in partnership with the Indiana University Richard Fairbanks School of Public Health and Weill Cornell Medical College.
SHIN-NY is a network-of-networks that includes eight regional health information exchanges (RHIOs) certified as Qualified Entities (QEs). Researchers in the NYeC study analyzed the rate at which users of SHIN-NY utilized ADT notifications and query-based exchange services from three QEs over a one year period. This preliminary report is the first part of a multi-phase study about the impact of QE services on healthcare costs and patient care delivery.
Ultimately, researchers found ADT notification utilization increased by 95 percent between 2016 and 2017, while query-based health data exchange jumped by 102 percent.
“This study demonstrates the SHIN-NY is working, usage is growing, and every day it is helping providers manage their patients’ care,” said NYeC Executive Director Valerie Grey in an emailed statement.
“Alerts and queries are free services offered to participating providers—we need everyone to get connected.”
Researchers also examined the ways different providers utilize QE services and found most alerts are sent from general hospitals, while home health and long-term post-acute care (LTPAC) providers are the most frequent recipients. Meanwhile, specialty care providers are most likely to request additional patient information after receiving an alert. Researchers found specialists request additional patient health data in response to one of every seven alerts within 24 hours.
"Alerts directly support and impact transitions of care across our 13-county region and the whole of New York," said Rochester RHIO President and CEO Jill Eisenstein. "They help our Rochester RHIO partners take more immediate and beneficial actions, resulting in a higher degree of efficient and effective patient care.”
While alerts sometimes lead to query-based health data exchange, researcher found healthcare organizations that receive a larger volume of alerts tend to send fewer queries for patient health data in response.
Researchers also noted differences in the ways providers respond to alerts about a patient being admitted to a healthcare facility compared to alerts about a patient being discharged. Overall, SHIN-NY providers are more likely to access query-based portal services within 24 hours of receiving discharge rather than admission notifications. Furthermore, alerts sent about a patient being admitted to an emergency department and an inpatient setting in the same day were most likely to result in an organization accessing QE query-based portal services.
Ultimately, researchers stated policymakers should take note that a variety of different healthcare organizations utilize alerts and query-based health data exchange technologies to access patient information. Additionally, researchers emphasized that sending continuity of care documents (CCDs) along with alerts decreases the need for providers to request access to additional patient information.
“Our participants have come to rely upon clinical alerts for helping to manage patients with complex issues,” said Healthix President and CEO Tom Check. “To better support care management workflows, Healthix provides clinical summaries or CCDs with alerts, pushing data to providers so they receive the patient’s clinical history with the alert. This enables them to make real-time clinical decisions.”
The next phase of the multi-part study will analyze the ways alerts and query-based health data exchange improve patient health outcomes and cut costs for healthcare organizations in a variety of care settings.
“With our ability to alert providers of their patients’ admissions and discharges to healthcare facilities, including local emergency department visits in real time, and the ability to query HEALTHeLINK to understand what happened with their patient during that visit, care coordination is enhanced greatly,” said HEALTHeLINK Executive Director Dan Porreca.