Case Study Background
Prior to using Direct Secure Messaging, Union Hospital communicated with its extended network of agencies, long-term care facilities, payers, providers, patients and other entities primarily through mail, fax and printed patient records. This method was inefficient, error prone and difficult to keep secure. In addition, the hospital allowed external care teams remote access to its EHR system. This added complexity and cost, while lowering security levels because it required Union to maintain Active Directory and VMWare licenses for authentication. Additionally, this approach created numerous silos of information that further complicated efficient patient information exchange. Finally, it was difficult to track what happened with a patient once they were discharged and whether they were continuing to follow their care plan.
- Enable electronic data exchange, via MEDITECH EHR, internally and externally to provide more efficient workflows, while ensuring compliance with regulatory requirements
- Accessible and easy to use by a wide variety of end-users including care coordinators, patients, care givers, clinicians and administrators.
- Extensible to accommodate emerging secure messaging protocols
- Easy electronic health information exchange across multiple health information exchanges (HIEs)
- Enhancing the patient /provider experience and improving quality of care
- Mobilize clinical data exchange with referral partners in accordance with national standards
Union Hospital faced multiple challenges including a cultural “love of paper.” Employees, patients and providers were all used to working with paper records and needed to buy into the benefits of sending and receiving patient information electronically.
Getting the right data to the right place at the right time, and minimizing data duplication, was also a challenge. The large number of sources for patient information introduced numerous opportunities for errors. Because the hospital serves a large rural area, it has an extensive network of providers, agencies, payers and other entities with which it needs to exchange patient data. Each entity was used to exchanging directly with the hospital, creating multiple silos of data and duplication, as well as extra cost for the hospital to support each interface.
Because of Medicare/Medicaid requirements, patient re-admittance rates needed to be kept low. However, tracking patient compliance with care plans once discharged was difficult with paper and faxed records. The dissociation of patient admissions, discharges and consecutive events of care were overly cumbersome to manage, track and mitigate on paper due to the widely varied exchange protocols deployed across the care community. Post-discharge providers used a myriad of different EHR and non-technical solutions to receive the discharge plan and drive patient compliance with discharge instructions.
Unlock Your Potential Today
Empower Your Potential with DataMotion Direct Secure Messaging
Direct Secure Messaging was implemented through Union Hospital’s MEDITECH EHR, to replace the use of mail, fax and the printing of patient records, resulting in enhanced information exchange with its extended network. Transmitting structured data documents (CCDs) via Direct alsoimmediately enabled interoperable exchange with HIEs and EHRs.
Interoperability with regional HIEs transformed Union’s clinical communications. The Hospital began encouraging external entities to exchange with them, using Direct Secure Messaging, through one of the two HIEs the hospital participates with – CRISP and DHIN – eliminating many individual interfaces to the hospital’s systems. The hospital also began receiving notices from CRISP (using Direct) regarding patients who had been discharged and then readmitted elsewhere. These notices, received every morning from CRISP, enabled case managers to better assess risk of re-admission for these patients.
“Use Direct Secure Messaging as a tool to drive change in your organization.It gave us the opportunity to leverage the electronic records we already had and became a change agent for making the exchange of data truly meaningful,” said Bonnie Davis, director health information services and management, Union Hospital. “Improving outcomes results in patient satisfaction. Using a communication standard like Direct to achieve those improved outcomes extends the opportunities for satisfaction and communication and is ultimately the key to ongoing evolution and improvement.”
The use of Direct Secure Messaging at Union Hospital has resulted in cost savings in multiple areas, as well as greater efficiencies, security and quality of care. For example, by using Direct to exchange CCDs the Hospital no longer needs to print and fax these records, saving them money and making the process of exchange more secure, efficient and less error-prone.
By encouraging providers to go through the HIE – using Direct Secure Messaging rather than an individual connection to the hospital – Union has saved money from not incurring the cost of supporting dozens of individual interfaces from these providers and other entities in their extended network. This also included a reduced need for Active Directory and VMware licenses, authentication licenses, Duo 2 factor authentication and the internal resources to support these interfaces.
Another benefit to the providers and to the hospital is that they all have access to each other’s information easily through the HIE. Also, an additional area of cost savings came through the daily notification messages sent from the CRISP HIE to Union Hospital’s case managers. These daily messages enable the case managers to monitor patients more closely and effectively, reducing re-admission rates – and has a direct impact on reimbursement from Medicare. “Our ability to share data is greatly enhanced,” continued Davis. “The use of DataMotion Direct Secure Messaging enables us to easily participate with our trading partners and leverage the state information exchanges in our area. The identity and security framework of Direct provides a truly trusted solution for information exchange between provider, systems and patients. No other communication methodology meets the high standards of privacy and security and yet provides easy avenues of communication regardless of system or enterprise.”