Right Care Alerts: Notifications of Improper Emergency Department Utilization

Contexture has developed Right Care Alerts to assist ED clinicians by providing them with real-time information on their patient’s ED/Inpatient utilization, so ED clinicians can make fully informed decisions and provide the best care possible.

Contexture’s Right Care Alerts bring ED and inpatient visit data across all participating organizations in the Arizona health information exchange (HIE) together to the point of care in the ED in real-time, providing immediate care and appropriate interventions for post-discharge care.

When a patient presents at the ED, the HIE is queried and sends a Right Care ED Utilization Risk Report back into the originating Electronic Health Record (EHR) system.

Problem to be Solved

• Many patients with complex care needs continue to utilize the emergency department and inpatient admissions to address their health needs, which results in higher costs.
• Right Care Alerts give ED clinicians the information they need to make fully informed decisions so they can provide the best care possible.
• In this new era of value-based care, Right Care Alerts provide ED clinicians real-time information that can be used to help direct patients to the most appropriate follow-up care, reducing ED and hospital inpatient readmissions and lowering healthcare costs.

“Contexture is in a unique position to offer valuable ED notifications that empower providers to have real-time insight into improper utilization. In addition to receiving virtually all ADT alerts in Arizona, Contexture also provides clinical information about the patient captured in the HIE not available by other ED notification services.”– Ryan Sommers, PMP, System Director, HIE & Interoperability, IT & Digital, Dignity/CommonSpirit Health

Solution

• Right Care Alerts help improve patient outcomes by informing ED clinicians which patients have a high number of ED visits and hospitalizations over the last year. This also informs ED clinicians that their patient’s healthcare needs are rising, and the patient is utilizing the ED rather than meeting with their primary care provider to address their complex care needs.
• Right Care Alerts are one of Contexture’s dynamic alerts, which leverage the HL7 ADT integration between the hospital’s EHR and the HIE, thus eliminating the need for a patient panel to be uploaded.
• Right Care Alerts have the following three (3) threshold parameters, which can be customized according to the participant’s desire:

A seven-day lookback report is generated and sent to the ED directors, physicians and other champions.

Purpose

• A compilation/summary of all Right Care Alerts received in the past seven (7) days.
• As opposed to individual alerts, the seven-day lookback gives ED directors a single report listing all the alerts they received based on the ADTs their ED sent to the HIE.
• A report featuring the patients who were in their ED/Inpatient facility and met the thresholds.

Goal

• Care Alerts are aimed at reducing ED/Inpatient readmissions, lowering healthcare costs and directing patients with complex care needs to the most appropriate places for follow-up and care.
• Our goal is to provide Right Care Alerts as a new service to HIE participants that operate an ED/Inpatient facility and any other participants interested in receiving this information.

Get Started
Arizona HIE participants who want to receive Right Care Alerts should contact their designated account manager or email HIEsupport@contexture.org.