The invaluable benefit of finding out in real time when a Member or Patient is in the Hospital

By Lesley Brown, SVP of Project Management at Halfpenny Technologies

Keeping track of when a member is admitted to the hospital is critical for both the patient’s health plan and their physician.

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Many health plans receive utilization data from their associated hospitals, but how frequently and how quickly does this occur? And primary care physicians rarely find out their patient has been in the hospital until their next office visit. The result – all too often, your patient has left the hospital before you were informed they were admitted!

Admission, Discharge, and Transfer (ADT) HL7 messages are ubiquitous in hospital information systems and communicate a patient’s state (admitted, discharged etc.) and when their personal or demographic information has changed. Timely notification of an inpatient hospital stay, an emergency room (ER) visit, or transfer to another facility via these apparently simple but ever present messages can be instrumental in supporting care coordination. Assistance with helping to reduce hospital readmissions comes to mind when we talk about hospital events but the near real time tracking of utilization events can have a much broader impact.

Imagine knowing a member has been admitted to the hospital for an exacerbation of a chronic condition such as congestive heart failure or COPD. How impactful would it be to have knowledge of that before the patient is discharged and to visit that member right there in the hospital? Research has shown that patients are more accepting and acquiescent to suggestions and changes to their health when they are in such situations. This time could be invested to review a care management program that would be beneficial for them to enroll in and to help them understand their plan of care. Notably, the time can also be used to improve member’s exposure to their health plan and transition their insurance provider’s image from one centered around billing to one focused on care coordination. For health plans, care managers who are located in hospital locations or patient centered medical homes, real time knowledge of utilization events can drastically improve their effectiveness and impact.

Looking for some assistance in obtaining meaningful clinical data such as ADT HL7 messages so you can be notified immediately of health care encounters? Halfpenny Technologies Hospital Utilization Notification Solution can provide you with real-time, customized information around a member’s hospital events including ER and inpatient admissions, changes in level of care, transfer to another facility and discharge. In the case of a trigger event you can be notified immediately via text or email providing the opportunity for instant contact and communication. Halfpenny Technologies’ continued investment in innovative solutions uniquely positions the company as a national provider of clinical data exchange solutions to the health care industry.

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