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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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Event Notification Service
A Service of the Florida Health Information Exchange
Presented by Milly HardinMay 20, 2014
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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
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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%)
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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
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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
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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
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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
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