Driving Health Outcomes with Electronic Notifications
Using event-based and quality of care alerts support interdisciplinary workflows to improve the health of populations.
How well are you using your technologies to support care coordination and population health?
At KPI Ninja we support payers, health systems, risk-bearing organizations and providers in ways that go beyond electronic notification requirements. Our technology supports you to not only be successful with Centers for Medicare and Medicaid Services (CMS) new requirements but performance improvement as well. We receive many questions regarding the different types of notifications, the benefits and how we do it. Let’s dive in.
Three Types of Electronic Notifications
|Binds care settings. CMS admission, discharge, transfer notifications that are useful for alerting team members of a new clinical event in a simple way.||A quality of care notification. Typically, an enhancement of an event-based alert with additional logic to address a specific performance domain.||Drives quality at the source with customized algorithms. Think of it as a flag that triggers a clinician to do something differently in their workflow to impact a health outcome.|
The most straightforward form of electronic notifications. The purpose is to help provide coordinated care across providers and care settings. We consider these to be event-based alerts, meaning that upon a patient’s admission, transfer or discharge from a hospital or emergency room, a care team member is alerted of the encounter to seamlessly provide follow-up care. Implementation of these alerts help you meet CMS’s new Conditions of Participation requirement.
Generally speaking, standard alerts are created with more straightforward logic and implementation of industry data exchange standards.
Used by care teams looking to optimize their improvement efforts. In many cases, this done by broadening the definition of a “care event”, then setting parameters on when the notification should occur. Many of these alerts come pre-built within Ninja Universe, and the reason for this is their close resemble to quality measure specifications (although the specs can easily be modified to fit your needs).
Examples include notifications for emergency room high utilizers, when a new procedure is completed (i.e. a colonoscopy), when a patient’s laboratory results reveal the presence of a new condition (i.e. COVID-19) or a disease management opportunity (hemoglobin value above 9.0% indicating poor control).
Just may be one of the more effective tools to empowering clinicians and positively impacting health outcomes. Using individualized algorithms that match workflows, these alerts guide and inform service delivery in a targeted way.
How is this possible? The data is pulled in from multiple sources, transformed with a Unified Data Model that implements complex logic based on your requirements, and then delivered out in a specified way. Irrelevant of the technology infrastructure you are operating in, we do the heavy lifting to get you the data you care about and can act upon to drive outcomes.
As you can imagine, custom alerts come in many forms. Working with organizations and care teams across the industry, we can provide many different examples of what this looks like in practice. For a physician’s office, this may be aggregating data from their claims and electronic health record system to create proactive care gap alerts. Or, it could be an Accountable Care Organization that has integrations with health plans, hospitals and providers (all with different technologies) to send role-specific alerts. Or, for health plans, sending an alert with a CCD-A document for newly enrolled members.
Analytics are an important component to the success of any population health effort but essential when managing ever-evolving interoperability requirements. In a previous blog post, we provided a compelling argument for why you should consider using a comprehensive platform to meet CMS’ new electronic notification requirement. And, this article covered one of the unique ways that KPI Ninja can help you beyond a compliance standpoint. Let us help you get the most of your technology to meet all of your care coordination and population health goals – get a call scheduled today.
About the Author
VP of Population Health at KPI Ninja, Inc.
Renee provides operational leadership of quality initiatives at KPI Ninja. Towne has a background in occupational therapy, education and experience in operational excellence across a variety of healthcare domains. Based on prior experience as a clinician that drove outcomes patient by patient, she is leaving a larger footprint by improving health care more comprehensively, population by population.
About KPI Ninja
KPI Ninja is a data analytics company that helps healthcare organizations accelerate their quality, safety, and financial goals with a unique combination of software and service. We are differentiated by our signature mix of technology, performance management consulting and healthcare expertise. We don’t merely offer software solutions but work shoulder to shoulder with clients to help them draw on the power of analytics and continuous improvement methodologies to become more efficient. In harmony with our data-centered ethos, we truly believe that our success is strongly co-related with yours.