DHIN Launches Encounter Notification System For Two Medicaid MCOs

Baltimore, MD/Dover, DE, September 30, 2013 –The Delaware Health Information Network (DHIN), is now delivering daily hospital encounter notifications to a Medicaid managed care organization (MCO) to support its care coordination efforts in Delaware. DHIN, in partnership with Audacious Inquiry (Ai), successfully launched the Encounter Notification Service (ENS) on Friday, September 20.  DHIN, founded in 1997, is one of the nation’s oldest and most successful statewide health information exchanges (HIEs).
The mission of DHIN is to facilitate the design and implementation of an integrated, statewide health data system to support the information needs of consumers, health plans, policymakers, providers, purchasers and research to improve the quality and efficiency of health care services in Delaware. Among DHIN’s five primary goals that serve as the basis for interoperability among all health care providers in the State of Delaware, Ai’s ENS can be instrumental in the goal to improve communication among healthcare providers and their patients, to provide the right care at the right time based on the best available information.
Through implementation of ENS and other key HIE technical services, Ai supports DHIN’s vision of enabling the exchange of clinical information among all health care providers across the state to improve outcomes while reducing service duplication.
“DHIN is thrilled to meet our strategic goal of providing encounter notifications to our customers in Delaware,” said Mark Jacobs, CIO at DHIN. “This go-live marks the beginning of a longer term strategy to provide hospital encounter notifications to all payers and providers in Delaware.”
ENS, powered by Ai, delivers real-time, encrypted notifications to interested parties such as primary care practices, patient-centered medical homes, hospital readmission programs, and managed care organizations when patients under their care experience a hospital-based encounter. Today, providers and others with care coordination responsibility may not know when one of their patients is admitted to a hospital, or they may find out well after the hospital event. ENS supports hospital communication with primary care providers and care managers to promote care coordination, reduce readmissions, and prepare for new payment models.
ENS utilizes core infrastructure which many health information exchanges and hospital systems already operate—such as demographic feeds and master patient indexes. Ai developed ENS in response to demand from its statewide health information exchange customers, as a way of capitalizing on existing infrastructure to drive business value for HIE participants and help ensure HIE sustainability.
“ENS is the product of two basic insights we have gained in the last five years of work with HIEs,” said Scott Afzal, principal of Ai. “First is that the basic demographic feeds which many HIEs have established with facilities throughout their service area are undervalued and include lots of impactful information. Second is that patient matching—master data management—is one of the most important things an HIE does, if one does it well. The solution capitalizes on these insights to put actionable information in the hands of the right caregiver at exactly the right time.”
ENS allows for rapid deployment and time to value for both HIEs and their participants. It holds a clear value proposition for the following groups:
Hospitals – ENS helps hospitals regulatory compliance, such as CMS A-0133 which states, “The patient has the right to have a family member or representative of his or her choice and his or her own physician notified promptly of his or her admission to the hospital.”
Ambulatory providers – CMS recently approved two new transitional care management (TCM) CPT codes to reflect non face-to-face care management work involved in primary care. Reimbursements began on Jan 1st, 2013. According to AAFP, payments are estimated to total $600 million in 2013. Incentive payments under the new TCM codes range from $135-$231 per patient.
Insurance plans, managed care organizations and ACOs – ENS supports responsive case management, delivers up-to-date member contact information, and supports a range of quality initiatives.
Audacious Inquiry is responsible for the planning, implementation, and maintenance of its proprietary solution called the Encounter Notification Service® (ENS) for DHIN. ENS can send secure alerts in several ways, including, via a secure web services connection, via Direct secure messaging technology, or via the ENS PROMPT user interface. ENS can rapidly drive measurable clinical improvements in quality and outcomes, and can be integral to initiatives around population health, transitions of care, and reduction of readmissions. Since its commercial launch in 2013, ENS has over 10 million hospital encounter notifications distributed securely to HIE organization subscribers across Florida (FL HIE, AHCA), Utah (UHIN, cHIE), Delaware (DHIN), and Maryland (CRISP), as well as metro Philadelphia (HSX of Southeastern PA) and the District of Columbia. Please click here for more details.
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Ai leverages domain expertise in health information policy and technology to offer bold technology solutions that are leading the way to smarter delivery of healthcare. Commercial, government and nonprofit healthcare organizations have turned to Ai to rethink how health information is shared, managed, leveraged, and protected. Ai’s implementation of master data management (MDM) tools to enable health information exchange has set the standard for health information organizations (HIO/ HIEs) throughout the nation. Ai’s Encounter Notification Service (ENS®) solution provides reliable, real-time notifications and clinical summaries to primary care providers, payers and other healthcare stakeholders of patient hospitalizations. ENS offers a more efficient and cost-effective way to coordinate care. For more information visit www.ainq.com and follow on Twitter @A_INQ.