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The Interoperability and Patient Access Final Rule: the importance of PACs

One of the Conditions of Participation (CoPs) created by the Interoperability and Patient Access final rule is the requirement for hospitals with an EHR – including critical access and psychiatric hospitals – to send electronic patient event notifications (ADT notifications) for admissions, discharges and transfers to primary care providers (PCPs), physicians and post-acute providers (PACs) and suppliers. Incorporating critical stakeholders such as PCPs and PACs into the patient journey means better outcomes and more collaborative relationships between providers at different levels of care. Below, we explore potential opportunities for post-acute providers through this new e-notification requirement.

Strengthened relationships with acute provider partners

Currently, many post-acute providers have limited visibility into a patient’s care beyond the post-acute setting and receive no notifications when their patients are hospitalized, appear at the ED or are readmitted. Under the final rule, post-acute providers should be alerted when their patients enter and leave hospital settings, promoting information sharing and care coordination activities between the acute and post-acute levels of care.

Informing PACs regarding a patient’s status, and incorporating post-acute partners into the patient journey, is critical to delivering high-quality, coordinated care and improving patient outcomes. Through streamlined workflows, and more timely patient interventions and follow-ups, electronic patient event notifications help PACs foster stronger, more communicative relationships with referral facilities.

Improved ED diversion and continuity of care

Under the final rule, a patient’s previous post-acute provider will receive an alert if a patient presented to the emergency department. Increased insight and visibility into a patient’s location and care within the continuum means that post-acute providers can more easily intervene to prevent a rehospitalization by working with the hospital to redirect the patient back to the post-acute facility before an admission occurs. By communicating with ED case managers, PACs can help direct a patient’s care to ensure that the appropriate treatment at the appropriate level of care is received.

Electronic patient event notifications help post-acute facilities monitor patients and trends to make better future decisions for cost savings and improved outcomes. CarePort supports deeper analysis of ED visit data, offering post-acute providers access to utilization trends that empower them to take future actions to decrease overutilization of high-cost care settings. ADT notifications will also prove beneficial to PACs working to adhere to regulatory requirements such as the SNF Value-Based Purchasing Program, wherein SNFs are held responsible for hospital readmissions within 30 days of a patient’s post-acute discharge. 

CarePort can help hospitals comply with the final rule. Our suite of solutions enable providers across the continuum – hospitals, ACOs, physician groups, payers and PACs — to coordinate care through real-time, actionable notifications. CarePort provides visibility into admission, discharge and transfer events across a network of 1,000 hospitals in 43 states and leverages an existing electronic network of over 20,000 post-acute providers nationwide. Through this data and information sharing, provider relationships are strengthened and connectivity with referral partners is improved. Using the CarePort platform, which already processes 40% of hospital transitions to post-acute providers in the U.S. every year, a patient’s provider receives real-time contextual clinical alerts regarding a patient’s status via text or email, allowing them to monitor patients and intervene when necessary to redirect patients to the appropriate level of care and prevent readmissions.

We’re hosting a webinar on April 22, 2020 with Lissy Hu, CarePort CEO and founder, and associates from Foley Hoag, to learn more about the final rule and its e-notification CoP, and to discuss compliance requirements for your hospital or organization. Register here.

Learn more about the final rule’s e-notification CoPs, and reach out to learn how CarePort can help your hospital or organization comply with the new CoPs as part of the final rule.

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