On May 1, 2021, it becomes a requirement for hospitals, as well as psychiatric hospitals and critical access hospitals, to comply with the Interoperability and Patient Access Final Rule’s requirement to have the ability to send admission, discharge, and transfer (ADT) event notifications. Those who do not comply by this date are no longer eligible for Medicaid and Medicare reimbursements. So, if your organization hasn’t already taken the steps to comply or you haven’t read up on this requirement, then the time to do so is now. Here are a few key things we think you should know in order to comply with the ADT event notifications requirement.
What are ADT Event Notifications?
Admission, discharge, and transfer notifications aren’t a new concept. In fact, some health information exchanges (HIEs) have been capable of sending them for years. What is new, is the requirement for hospitals to send these types of notifications. According to the Centers for Medicare & Medicaid Services (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.”
The best way to further explain this is with a brief example. Let’s say you go to the emergency room for chest pains. Upon your admission to the ER, they’ll identify the members of your care team – such as your primary care provider (PCP) and any other specialists that you see. After identifying this information, a notification will be sent to the members of this team that would be the most concerned with your latest health status. In this scenario, that would likely consist of your primary care provider and your cardiologist. If, during the course of your care, you are transferred to a post-acute care facility or a rehabilitation center, a notification of this transfer will be sent as well. Finally, once you are discharged, another notification will be sent alerting your care team that you have been sent home so they can schedule follow-up appointments as necessary. Due to this newest CMS mandate, the hospital must have the ability to send each of these notifications. However, if they are unable to identify the members of your care team and you are unable to provide them with this information, then they are under no obligation to send an ADT event notification.
So, to put it in perhaps oversimplified terms, ADT event notifications require hospitals, psychiatric hospitals, and critical access hospitals, to notify the relevant members of your care team whenever a change in care occurs as long as they can be identified.
What needs to be included in a notification?
Healthcare organizations are busy and already inundated with enough data as it is. So, ADT notifications need to be formatted and sent in a way that is easy-to-process by systems and easy-to-consume by individuals. 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.” Including this information makes it easy for individuals to read, understand which patient the notification corresponds to, and view an update on their most recent health status. It also provides some basic fields to assist with routing the message to the right department on the receiver’s end.
What kinds of benefits do patients receive from these notifications?
The goal of ADT notifications is to improve the quality of a patient’s care, improve post-care outcomes, and reduce hospital readmissions. This article by DirectTrust™, a key enabler of healthcare interoperability, provides an excellent, real-life example of how ADT notifications can improve patient care before, during, and after treatment. It explains how sending a notification of ER admission to the patient’s primary care provider, enabled the PCP to immediately get in contact with the treating practitioner to provide necessary information regarding the patient’s prior health. Thus, allowing the practitioner to make more informed decisions while treating the patient.
Likewise, following the patient’s treatment, the article highlights how a discharge notification instantly alerts the PCP, so they know that it’s time to schedule a follow-up appointment. This is essential for ensuring that the patient receives the proper care following discharge and to reduce the likelihood of them being readmitted to the ER.
So, in summary, these ADT notifications are a big step forward to increasing the ability for physicians, regardless of if they have treated the patient before, to make informed decisions regarding their care. Resulting in better outcomes and reduced hospital readmissions.
Do recipients need to prepare in any way to receive ADT notifications?
Technically, there is no requirement for hospitals and other healthcare organizations to be able to properly receive and process these notifications. The CMS requirement simply states that hospitals need to have the ability to send a notification in order continue to receive Medicare and Medicaid reimbursements. However, as was alluded to before, many of the benefits of ADT notifications stems from what happens after an event notification is received.
Think of the previous examples of the PCP calling the ER to provide them with a summary of the patient’s health information or the PCP following up to schedule an appointment after receiving an alert that the patient has been discharged from the hospital. Neither of these actions would have taken place if the recipient did not have an organized method of receiving and processing the notifications.
With that being said, there are a couple of ways that recipients can prepare for receiving ADT notifications, mainly related to their provider directory. DirectTrust recommends that those organizations who expect to receive ADT notifications should ensure that all their information in the provider directory is accurate and up to date. In addition, they should verify who in their organization should receive each type of notification in order to ensure that every notification received is routed to the right department. This will, in turn, make it easier for them to accurately address each notification in a timely manner.
How can I enable ADT notifications at my hospital?
As was mentioned previously, hospitals and other healthcare organizations have been sending ADT notifications in some form for years. So, it makes sense that most hospitals already have existing services and technologies in place that they can leverage to enable the sending of event notifications. One existing and widely used technology that can enable these notifications is Direct Secure Messaging. Direct Messaging enables the simple, secure, and compliant exchange of healthcare information between organizations. According to DirectTrust, utilizing Direct grants the shortest path to compliance with the CMS ADT Notifications.
In order to properly utilize this technology to enable ADT notifications, DirectTrust created the Event Notifications via Direct Standard™ Implementation Guide. This guide highlights sample use cases for using Direct to enable notifications as well as provides additional context and content requirements for messages and message metadata.
DataMotion is a DirectTrust accredited HISP, CA, and RA and a proud member of the DirectTrust network.