Since 2021, the Interoperability and Patient Access Final Rule from the Centers for Medicare & Medicaid Services (CMS) has required hospitals, psychiatric hospitals, and critical access hospitals to send patient admission, discharge, and transfer (ADT) event notifications. These notifications play a crucial role in improving care coordination, reducing readmissions, and ensuring timely follow-up care.
For healthcare organizations, ongoing compliance and optimization of ADT notifications remain essential to maintain eligibility for Medicaid and Medicare reimbursements and to improve interoperability and secure patient data exchange across various networks. Many hospitals have adopted DirectTrust™-accredited Direct Secure Messaging networks to streamline ADT notifications, ensuring they meet CMS requirements while maintaining secure patient data exchange between care providers.
What are ADT Event Notifications?
Patient admission, discharge, and transfer notifications aren’t a new concept. Health Information Exchanges (HIEs) and some hospitals have been using them for years to enhance care team communication. However, with the CMS mandate, hospitals must ensure that these notifications are sent reliably and securely.
According to the CMS, ADT notifications are:
“Electronic patient event notifications of a patient’s admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner.”
These notifications are transmitted via ADT feeds, continuous data streams that integrate with electronic health records (EHRs) to provide real-time updates on a patient’s status. This allows care providers to receive immediate alerts when a patient is admitted, discharged, or transferred, ensuring timely coordination and follow-up care.
To comply with CMS ADT regulations, hospitals, psychiatric hospitals, and critical access hospitals must notify a patient’s known care team whenever a change in care occurs, provided these team members can be identified.
What Needs to Be Included in an ADT Event Notification?
Hospitals and care teams are inundated with data, so it’s essential for ADT notifications to be structured for both system readability and human usability. According to CMS, ADT notifications must “convey, at a minimum, the patient’s basic personal or demographic information, as well as the name of the sending institution (that is, the hospital), and, if not prohibited by other applicable law, the patient’s diagnosis.”
To ensure efficient processing and accurate routing, ADT notifications typically include:
- Patient’s Name
- Date of Birth
- Notification Type (admission, discharge, or transfer)
- Primary Diagnosis (if permitted by law)
- Condition Status
- Sending Institution Name
Standardizing these fields helps streamline patient data exchange, ensures compliance, and improves interoperability across healthcare systems.
How ADT Notifications Work in Practice
To better understand how ADT notifications work, let’s look at an example. When a patient visits the emergency room for chest pains, the hospital will try to identify the members of their care team that would be most concerned with the patient’s latest health status, such as their primary care provider (PCP) and cardiologist. Upon admission, a real-time ADT notification will be sent to these providers, allowing them to stay informed about the patient’s status. If the patient is later transferred to a post-acute care facility, a rehabilitation center, or is discharged, additional notifications will be sent so the care team can ensure timely follow-up care. If the care team cannot be identified, the hospital is not required to send a notification.
➡ For insights on how to analyze and optimize ADT data for predictive patient care, check out our guide on ADT Data Analytics.
Optimizing ADT Notifications Beyond Compliance
Even after initial implementation, hospitals must refine ADT workflows to improve interoperability, efficiency, and security—especially when transmitting ADT notifications outside centralized networks.
Key Challenges in Managing ADT Notifications
1. Security Considerations
Many hospitals rely on Direct Secure Messaging through an accredited Health Information Service Provider (HISP) within the DirectTrust network to secure ADT data transmissions, while others use Secure FTP (SFTP) and Virtual Private Networks (VPNs) to protect sensitive information. However, these methods require continuous IT oversight and regular security audits to remain HIPAA-compliant, leaving potential vulnerabilities if not rigorously managed.
2. Interoperability Across Healthcare Networks
While HL7 and FHIR standards improve interoperability, integrating ADT data with external providers often poses significant challenges. Custom-built solutions are sometimes necessary to achieve seamless EHR integration between hospitals, skilled nursing facilities, and outpatient clinics.
3. Regulatory Compliance and CMS Requirements
The CMS mandate primarily applies to hospitals that participate in Medicare and Medicaid. However, all healthcare entities receiving ADT notifications must establish workflows to ensure these message types are actionable. Maintaining audit logs, secure access controls, and HIPAA compliance remains an ongoing challenge.
4. Efficiency in ADT Transmission
Automated message routing through secure platforms minimizes delays and ensures that ADT notifications reach the right provider in real time. In contrast, hospitals that rely on manual FTP/SFTP transmissions may experience slower message delivery times and increased administrative burden, ultimately compromising the timeliness and reliability of ADT notifications.
The Benefits of Optimized ADT Notifications
Beyond compliance, ADT notifications empower physicians – even those treating a patient for the first time – to make informed decisions regarding their care. This improved decision-making enriches patient care quality, improves post-care outcomes, and reduces the recurrence of patient admissions. For healthcare organizations, ADT notifications further boost care coordination and outcomes with:
- Improved Patient Transitions: Ensuring timely follow-ups reduces emergency room revisits and enhances value-based care initiatives.
- Predictive Analytics & AI-Powered Insights: ADT data enables hospitals to identify high-risk patients and prevent unnecessary readmissions.
- Population Health Management: ADT notifications improve chronic disease management by keeping care teams informed.
➡ To ensure your ADT notifications are transmitted securely and in compliance with CMS requirements, explore our guide on best practices for ADT data analytics.
Best Practices for ADT Notification Management
For healthcare organizations looking to optimize ADT notifications, consider the following:
Hospitals & Healthcare Facilities
- Maintain updated provider directories to ensure ADT messages reach the correct care team members.
- Use secure, automated messaging to avoid manual processing delays.
- Ensure ADT notifications include relevant patient context per CMS guidelines for effective decision-making.
Care Teams & Providers
- Integrate ADT notifications into patient care workflows to facilitate real-time monitoring.
- Establish clear internal workflows for processing notifications within EHR systems.
- Train staff on best practices for reviewing and acting on ADT notifications to improve care transitions.
Looking Ahead: The Future of ADT Notifications
Since CMS regulations on ADT notifications took effect, the role of healthcare interoperability continues to expand. Emerging trends include:
- AI-Driven Care Alerts: Machine learning models will refine ADT notifications to provide smarter risk assessments.
- Broader Healthcare Data Exchange: Home health, telemedicine, and behavioral healthcare providers will increasingly integrate ADT data into patient care strategies.
- Enhanced Security & Compliance Measures: Healthcare organizations must continuously refine cybersecurity strategies to ensure their ADT messaging platforms remain secure, scalable, and HIPAA-compliant.
Final Thoughts
ADT event notifications have become a critical tool in modern healthcare, improving patient care, provider coordination, and operational efficiency. As healthcare organizations continue refining their ADT notification strategies, they must address ongoing security, interoperability, and compliance challenges.
By ensuring secure, efficient ADT transmissions, hospitals and care teams can maximize the value of patient data, enhance care coordination, and support better patient outcomes across the healthcare ecosystem.
Is Your Organization Optimizing ADT Notifications?
For organizations navigating secure ADT data exchange, evaluating and refining current notification workflows can ensure compliance, efficiency, and improved care coordination.
Reach out to learn how secure messaging solutions can help streamline your ADT notification process and enhance real-time healthcare communication.
DataMotion is a DirectTrust accredited HISP, CA, and RA and a proud member of the DirectTrust network.
