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Complying with CMS’s Interoperability Final Rule Using an Intermediary

Within CMS’s Interoperability and Patient Access Final Rule, one condition of participation (CoP) requires hospitals with an EHR, including critical access and psychiatric hospitals, to send electronic patient notifications for patient admissions, discharges and transfers to PCPs, physicians and post-acute providers and suppliers.

To reduce the burden of fulfilling these requirements, CMS’s final rule explicitly recognizes the ability of a third-party or intermediary to facilitate the patient event notifications, so long as the intermediary does not impose restrictions on which recipients are able to receive notifications. Within the rule, CMS notes, “We agree that the use of intermediaries to deliver patient notifications can reduce burden on hospitals and support effective notification systems.”

CarePort is uniquely positioned to serve as an intermediary, facilitating the exchange of health information on a hospital’s behalf and ensuring compliance under CMS’s new requirements. Transmitting ADT notifications by utilizing an intermediary such as CarePort may benefit hospitals in the following ways:

Deliver notifications to an established network

According to the final rule, intermediaries must be able to connect a wide range of recipients, and should not impose restrictions on which recipients are able to receive notifications. CarePort maintains a database of more than 100,000 post-acute providers to whom we send notifications. 40% of patient transitions in the U.S. already flow through our platform every year. In fact, CarePort already serves as an intermediary for its customers, connecting thousands of hospitals with physicians and post-acute providers across the country. Fueled by robust data sources, the CarePort platform has visibility into ADT events across a network of 1,000 hospitals in 43 states, and processes nearly 10 million patient events daily.

Tailored notifications to prevent “alert fatigue”

Under the final rule, hospitals or intermediaries can tailor the delivery of notifications based on the preferences of the receiving provider. The adoption of a patient event notification system should be paired with the adoption of processes and software that ensure that notifications are delivered to the right individual, and that the information is organized and actionable. The CarePort platform allows for customizable, configurable alerts, with the ability to opt out as needed. CarePort enables tailored notification preferences to individual provider organizations to reduce alert fatigue, or only provide alerts requested by that organization.

In the absence of care coordination technology, PCPs and post-acute providers may quickly suffer alert fatigue resulting from disorganized, untailored notifications. After all, how many providers have the resources necessary to sift through the slew of alerts that will result from the patient event notification requirement? To impact health outcomes and improve continuity of care for patients, the data being shared must be prescriptive and predictive, and should be sent to organizations in an organized, actionable way.

Clinical context to help care coordination between providers

Under these new CMS regulations, providers will be required to send patient event notifications – but how does that data become actionable? Alerts are necessary, but not sufficient in achieving coordinated care. When entire networks are connected and communicating, it’s not about just about receiving alerts to check a box – it’s the ability to coordinate care and successfully conduct patient follow-up post-discharge, manage value-based programs, oversee post-acute networks, optimize emergency department utilization and more.

In the end, interoperability is a means to achieving care coordination. CarePort’s interoperability solution provides access to a well-established network and fosters communication across disparate providers to achieve better care coordination across the continuum, and improve quality of care.

Contact us to learn more about CarePort’s interoperability offering.

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