1. Event Notification Service
A Service of the Florida Health Information Exchange
Presented by Milly Hardin
May 20, 2014

2. 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

3. 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%)

4. 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)

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. Sample Alert: As Available

14. Sample Alert: Daily Batch

15. Event Notification Service
Delivers timely, actionable information on members’ hospital encounters
Facilitates better care coordination and case management
Can be used to proactively prevent unnecessary hospital readmissions
Provides up-to-date contact information

16. Florida HIE Contact the Florida Health Information Exchange