Complying with CMS’s interoperability final rule using an intermediary

Within CMS’s Interoperability and Patient Access Final Rule, Conditions of Participation (CoPs) require hospitals with an EHR, including critical access and psychiatric hospitals, to send electronic patient notifications for patient admissions, discharges and transfers to PCPs, physicians and post-acute providers and suppliers.

 

Hospitals and health systems must comply with these new CoPs by May 1, 2021.

To reduce the burden of fulfilling these requirements, CMS’s final rule explicitly recognizes the ability of a third-party or intermediary to facilitate the patient event notifications, so long as the intermediary does not impose restrictions on which recipients are able to receive notifications. Within the rule, CMS notes, “We agree that the use of intermediaries to deliver patient notifications can reduce burden on hospitals and support effective notification systems.”

CarePort offers a complete offering to identify and notify primary care physicians, physician groups and post-acute care providers regarding patient hospital admissions, transfers and discharges. Leveraging an existing national network of providers and established workflows for sharing ADT information in real-time, CarePort is uniquely positioned to serve as an intermediary, facilitating the exchange of health information on a hospital’s behalf and serving as a one-stop shop for regulatory compliance under CMS’s new requirements. Utilizing an intermediary such as CarePort may benefit hospitals in the following ways:

Identify providers and deliver notifications to an established network
According to the final rule, intermediaries must be able to connect a wide range of recipients – both in and out of network – and should not impose restrictions on which recipients are able to receive notifications. CarePort can help organizations identify providers at the point of registration and discharge and manage the hospital’s list of post-acute providers and physicians so that hospitals and health systems do not have to do so. Integrated directly into existing workflows and post-acute provider systems nationwide, CarePort maintains a database of more than 100,000 post-acute providers to whom notifications are sent. With the ability to notify 850,000 direct message-enabled providers on ONC-certified EHRs, the CarePort platform is also a proven system for physician notifications.

When using CarePort to comply with CMS’s interoperability CoPs, there are no PAC or physician onboarding requirements. In fact, CarePort already serves as an intermediary for its customers, connecting thousands of hospitals with physicians and post-acute providers across the country – and 40% of patient transitions in the U.S. already flow through the CarePort platform every year. Fueled by robust data sources, the CarePort platform has visibility into ADT events across a network of 1,000 hospitals in 43 states, and processes nearly 10 million patient events daily.

Tailored notifications to prevent “alert fatigue”
Under the final rule, hospitals or intermediaries must make a reasonable effort to reach both in- and out-of-network providers, but can tailor the delivery of notifications based on the preferences of the receiving provider. The CarePort platform allows for customizable, configurable alerts, with the ability to opt out as needed. CarePort enables tailored notification preferences to individual provider organizations to reduce alert fatigue, or only provide alerts requested by that organization.

Ultimately, interoperability is a step towards improved care coordination – whether conducting patient follow-up post-discharge, managing value-based programs, overseeing post-acute networks or optimizing emergency department utilization. CarePort’s interoperability solution, embedded directly within a hospital or health system’s EHR, provides access to a well-established network and fosters communication across disparate providers to achieve better care coordination across the continuum, and improve quality of care.

Learn more about CarePort's interoperability offering.

Editor's Note: This article originally appeared on Allscripts' website

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