Regional health information exchanges with clinical event notification services have the potential to improve care coordination and possibly reduce unnecessary inpatient admissions and duplicate testing, according to a study in Generating Evidence & Methods to improve patient outcomes.
CENs alert appropriate stakeholders when a patient experiences one of a preset list of clinical events, such as an emergency department admission. The CEN service in this study, incorporated in Healthix, an HIE for the metro New York City area, includes several features the researchers believe to be unique — the CEN system sends alerts through multiple channels including email, text messages and EHR inboxes, as well as automatically entering the encounter into the patient's EHR.
The study tracked the effectiveness of the CEN system in meeting the goals of GEDI WISE, a program at Mount Sinai School of Medicine designed to improve care coordination among geriatric patients who present in EDs. During the one-year study period ended March 2, 5,722 GEDI WISE patients were enrolled into the CEN program, resulting in 497 unique CEN notifications. Of these notifications, 219 were for an ED admission, over half of which happened during the day and allowed the care coordination team to contact the ED directly while the patient was there.
CEN services "are a logical next step toward fully utilizing the potential of HIE," according to the study's authors, as they present an opportunity for providers to better coordinate care amongst themselves. "Although it could not directly be demonstrated here, we believe that widespread use of CEN systems has the potential to decrease avoidable admissions, testing and procedures, and thereby decrease costs," the authors wrote.
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