Event Notification Service

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 • 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 ENS allows Florida health plans to receive timely notice of member hospital encounters

9. Subscribing • 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 Health plans subscribe by providing a roster of current members (a panel) to the Florida HIE

10. Hospital Data • 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 • Participating hospitals provide the Florida HIE with copies of their ADT feeds

11. Receiving Alerts • 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 Once a match is made between the ADT feeds provided by the hospitals and the “subscribed to” panel provided by the health plan:

12. ENS Alerts Content of ENS alerts

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 • www.florida-hie.net • FLHII@ahca.myflorida.com • 850-412-3766