Readers Write: Hospitals Shouldn’t Skimp on Meeting May’s ADT Deadline

Hospitals Shouldn’t Skimp on Meeting May’s ADT Deadline
By Claudia Williams

Claudia Williams, MS is CEO of Manifest MedEx of Riverside, CA.

Time is running out. There is now just over a  week to go before the May 1, 2021 deadline for hospitals to meet the Centers for Medicare and Medicaid Services (CMS) regulation requiring hospitals to share event notifications with community providers when a patient is admitted, discharged, or transferred (ADT). If hospitals want to keep getting paid by Medicare and Medicaid, they need to act now.

While it may be anxiety-inducing to compliance and IT departments, this fast-approaching deadline will be a joyful milestone for patients and providers in the community. Studies have shown repeatedly that sending ADT notifications is one of the most impactful ways to enable care coordination and reduce readmissions after a patient is hospitalized. One University of Colorado Hospital study found that patients who didn’t receive follow-up by their primary care provider after discharge were 10 times more likely to be readmitted to a hospital.

The good news is that ADT notifications are easy, especially if hospitals work with a partner that can match and route messages to the right community provider. So easy, in fact, that in a 2019 letter in support of the rule, authors reported they “were unable to find a single example where a hospital was unable to send an ADT notification today due to lack of standards.”

But “meet the mail” approaches won’t cut it. Some hospitals and their vendors are making minimal effort to route notifications to the right community provider. That’s a risky move. This rule is about “delivering” ADT notifications, not just “generating” them, meaning these vital alerts must actually reach the health partners who need them in your community.

Non-profit health information exchanges (HIEs) across the country are a powerful solution for last mile delivery of encounter alerts. Exchanging data for more than 92% of Americans today, these statewide and regional networks have the infrastructure and information to ensure ADT notifications securely and quickly reach the right providers in your community. Hospitals simply share an ADT feed with the HIE. The HIE does all the heavy lifting of matching ADT notifications with the right providers and routing alerts to them in real time. Once notified, providers can act quickly to support patients and ensure they recover safely at home after a hospital stay.

Beyond ADT alerts, HIEs’ roles in care coordination are expanding rapidly. A 2020 report found that nearly all HIEs today have “partnered with one or more of the following community and social service organizations: correctional health, social service agencies, drug and alcohol treatment programs, first responders, school nurses, or blood banks.” With HIEs as partners, hospitals are more effective and efficient hubs of care coordination in the community, improving patient experience, strengthening relationships with referring providers, and resulting in better patient care. COVID-19 has shown just how crucial this collaboration is. New York’s HIEs reported delivering a record-breaking 10 million ADT notifications during the pandemic and doubled the number of patient record look-ups as healthcare leaders there struggled to keep patients safe.

Their report concluded that “Health information exchange (HIE) continues to play a vital role in the delivery and quality of patient care. In 2020, it was demonstrated and verified that the sharing of clinical information can be leveraged even further in support of population health initiatives, playing a role to help predict health outcomes for the coronavirus pandemic and other health care crises that may occur in the future.”

While the May 1 deadline is approaching fast, progress on interoperability is just getting started. HIE partnerships can help hospitals meet new ADT alert requirements but can also help them succeed in value-based care, strengthen community care coordination, reduce paperwork burdens, and improve patient care.