Medical Director's Corner: Just So YOU Know

Volume 2, Issue 2

Medical Director's Corner: Just so YOU know

Friends,

Recently, I met with the Community Collaborative Committee for the Monroe County Medical Society where I presented the need for having regional data standards around incoming ADT messages (Alerts). I believe we need to have a common language to ensure more consistent messaging in the Alerts users receive.

Having regional data standards around Alerts will improve the effectiveness of the Alerts service for 1.) Patient outcomes, 2.) Patients experiencing care transitions, and 3.) Alerts users. Providing users with more consistent detail supports improved decision making central to patient care.

In the past, Rochester RHIO only received ADT messages from area hospitals, but that has changed! Interoperability has significantly progressed over the last two years.

Tarun Kothari, MD, FACG, FACP

Medical Director

Rochester RHIO has more and more organizations sending ADT messages like skilled nursing facilities, home health agencies, urgent care centers, etc.

What are ADTs?

ADTs are Admit, Discharge, and Transfer notifications. They are the data transactions that create an Alert, or RHIO Alerts. They are the vehicle for communicating critical patient care transitions. The messages provide basic information about the event, and each patient's personal or demographic information (such as the patient's name, insurance, next of kin, and attending physician). Alerts also indicate when a status has changed (admitted or discharged).

Through the Rochester RHIO, Alerts are triggered by an admission, discharge, or transfer (ADT) event at a hospital (emergency department or inpatient treatment). The hospital's EHR sends that message to the health information exchange (Rochester RHIO).
Rochester RHIO processes the ADT message and transforms it into an Alert sent to the primary care provider, community-based care manager, or other provider.
The Alert message notifies the physician, care manager or other provider of the patient's status. The patient's care team can then initiate an intervention, if needed, improving the post-discharge transition.

Using Alerts assists other community partners with care coordination as well. For example, skilled nursing facilities use Alerts to record patient outcomes after a skilled stay. For example, they record patient re-admission rates to hospitals 30-90 days after a stay. This allows them to better manage the transitions for patients moving from a hospital setting to another care setting.

The goals of any ADT-based Alert Program is to:

Improve communication across care providers
Improve patient care management
Reduce unnecessary hospital admissions and re-admissions

As a physician who receives Alerts, I want to make sure that I have quality information at my fingertips when caring for a patient, and I want to make sure that our users have that same experience, too. I believe these standards will create a more usable solution. But it takes a village. With the support of the greater Finger Lakes community, ADT-based Alerts can be even better with consistent language and regional data standards. The goal of RHIO Alerts is to provide timely, accurate, and comprehensive demographic and clinical information to a clinician who can act upon the received message and affect high quality patient care.

Please feel free to contact me with any questions related to this effort. Of course, if you'd like to sign up for the Alerts service through Rochester RHIO, call our Support Center at 1-877-865-7446.

Hope you had a good holiday weekend!

Tarun Kothari, MD, FACG, FACP

Rochester RHIO Medical Director

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