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

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

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%)

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)

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

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

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

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

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

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

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

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

Sample Alert: As Available

Sample Alert: Daily Batch

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

Florida HIE Contact the Florida Health Information Exchange www.florida-hie.net FLHII@ahca.myflorida.com 850-412-3766