Health Care Innovation
In an ideal health care system where patient care is paramount, your primary care doctor would always be notified when you’re admitted to a hospital.
Trouble is, they’re not. But a new system that BCBSM is supporting provides doctors access to a daily electronic report alerting them when their patients are admitted or visit the emergency room at any Michigan hospital.
Under the admission, discharge, transfer and emergency room visit notification service, a primary care team receives electronic notification when one of its patients is admitted to a hospital or visits an ER, even if the doctor is not affiliated with the hospital. Blue Cross is also encouraging hospitals to transmit data from all patients into the system, even if they are not Blues members.
After receiving patient data from hospitals, the service matches patients with their primary care doctor and transmits the data to the relevant physician organization via a daily census report. Doctors can then follow up with their patients more quickly to make sure they receive the necessary care in the critical first days after leaving the hospital.
The notification system depends on the ability of physician organizations to regularly transmit updated patient registry lists, and it includes measures to safeguard patient privacy.
Physician organizations that participate in the service receive an incentive through Blue Cross’ Physician Group Incentive Program. Hospitals that participate will also receive incentives through Blue Cross hospital incentive programs. The statewide service is operated by the Michigan Health Information Network Share Services, or MiHIN, in collaboration with regional health information exchange organizations across the state.
“The ADT service is an important piece of improving patient care because it gives primary care doctors a single access point to timely information whenever their patients visit a hospital, regardless of health plan coverage or where the admission or ER visit takes place,” said Dr. Tom Simmer, the senior vice president and chief medical officer for BCBSM who also serves on the MiHIN board. “It reinforces a team-based approach to health care, makes the system more efficient and helps avoid unnecessary procedures or unplanned readmissions.”
Beaumont Hospital, Henry Ford Macomb Hospital and several Trinity Health hospitals are already participating in the service. Others, including St. John Providence Health System and the University of Michigan Health System, are preparing to follow suit.
Being able to better coordinate a patient’s care is a central pillar of BCBSM’s patient-centered medical home program. By establishing an electronic all-patient registry, affiliated physicians can more easily monitor when their patients visit hospitals with which the doctor has no relationship. That in turn helps doctors support the patient’s transition and minimize costly readmissions in ways that would have been difficult using paper-based records.
The ADT initiative has also been incorporated into the Blues’ value-based reimbursement contracting for hospitals.
Tagged With Cost of Care,electronic health records,health care quality,hospital reimbursement,Michigan Physician Group Incentive Program,Patient-Centered Medical Home,PCMH,PGIP,technology,Value Partnerships.