HL7 Version 3 Standard: Patient Administration is better known as ADT – Admission, Discharge, and Transfer. This administrative and demographic information has been helping with care management and coordination, as well as interoperability efforts, for some time now. Basic ADT messages include a patient’s full name, age, medical record number, diagnosis, and contact and insurance information. ADT feeds let Managed Care Organizations (MCOs) see and share a patient’s medical history with other providers in the care continuum. Plus, ADT systems securely store large amounts of patient data. But are ADT feeds the best resource for improving member outcomes?
In reality, ADT data is limited. It may be more current than claims data, but it still doesn’t give enough up-front information to fully impact patient care and outcomes, particularly for patients in post-acute settings. What’s a better alternative? MCOs can change the course of care and outcomes before negative events occur by accessing live patient data from post-acute EHRs.
History is Necessary, But Just Part of the Picture
Organizations rely on ADT messages for good reason. It’s important to know where their patients currently are and what they’ve experienced in the past. It’s useful in aligning with previous providers, leaving a footprint of prior care transitions and medical interventions.
But how much do ADT feeds help MCOs determine the best course of action for their members right now? If patients have moved on to post-acute care, the historical nature of ADT data can tell the providers and payers only where the patients physically reside. It doesn’t offer enough insight to positively affect patient management in the moment. Yes, it provides the “where” and “when” of patient status. But once an MCO learns of a patient alert via an ADT feed, it’s too late to prevent the circumstances that caused that alert in the first place. What’s missing is “what” and “why” this occurred and the “how” it can be prevented to the patient today in that post-acute setting that will impact the quality and cost of their care.
Live Post-Acute Analytics Takes Patient Management from Reactive to Proactive
With a view into patient condition from live post-acute electronic health record (EHR) data provided by Real Time’s platform, providers and payers can easily see which patients are stable, and which may be showing signs – even subtle ones – of a change in condition. Accessing that current information from their EHRs can make the difference between post-acute patients progressing positively towards the next transition or bouncing back to an acute readmission.
So, what is the “secret sauce” of the post-acute patient EHR information? Interventional Analytics. By scrutinizing both structured and unstructured data from multiple EHRs and establishing a baseline for the PAC patients upon arrival, our platform makes it possible to act quickly to avert adverse events. MCOs don’t have to “predict” anything; they have live post-acute analytics that enables them (and their PAC partners) to intervene proactively and collaboratively based on immediate conditions.
Drive Better Outcomes in the Here and Now
Sharing ADT feeds is an important part of the healthcare industry’s push towards full interoperability, but it doesn’t drive improved care outcomes. Accessing live post-acute analytics enables early identification of patient condition changes, allowing MCOs to intervene in care before adverse events occur. Patients and their families want the best outcomes, wherever they are in the continuum. And MCOs want to be able to share data-based best practices with their network PAC providers to improve care and transitions. Using live post-acute analytics from the PAC EHRs, those goals are achievable!
ABOUT THE AUTHOR
With over thirty-five years of health care experience in acute care, ambulatory care, and post-acute care, Phyllis Wojtusik has led the development of post-acute networks, participated in the Medicare Shared Savings Program and other value-based contract programs. Prior to joining Real Time Medical Systems, Phyllis led the development of a preferred provider SNF network for PENN Medicine Lancaster General Health. In this network she developed and implemented strategies that reduced total cost of care and readmissions while improving quality measures and patient outcomes. She utilized system approaches, clinical standards and care management tactics to improve coordination and transition of care while reducing post-acute length of stay in a network of non-owned SNFs.