Bronx Regional Health Information Organization Subscription Alert Services

Patients often seek care from multiple providers and organizations. Unfortunately, communication between providers is often inefficient and ineffective. Health information technologies can support better sharing of information among heath care organizations and address these challenges.

One of the services supported by the advancement in health information technologies is alerts. Alert services automatically notify a healthcare provider when a patient of theirs has been admitted to a participating hospital or emergency department. Alerts are real-time, electronic, automatic, and delivered to providers in accordance with state and federal privacy regulations. Alerts give healthcare organizations the opportunity to intervene in a timely fashion with care coordination activities and better management of follow-up visits, further supporting Performing Providers Systems (PPSs) in achieving their Delivery System Reform Incentive Payment (DSRIP) Program goals and broader efforts to improve patient care and reduce hospital readmissions.

In New York State, all Qualified Entities (QEs) offer alert services to enhance the flow of information between settings of care. Alert services are part of the minimum core services provided by the Statewide Health Information Network for New York (SHIN-NY).

In a recent study conducted under the direction of Cornell-Weill Medical College, evidence from multiple years of Medicare data paired with the centralized analytic database of the Bronx RHIO, suggests that alert services help avoid hospital readmissions and reduce healthcare costs.

More than 14,000 hospital admissions among a cohort of Medicare beneficiaries living in the Bronx were followed from 2010 through the first half of 2014. All of these beneficiaries were enrolled in the Bronx RHIO’s alert services at some point during this time period. When alerts were active, the 30-day readmission rates among this cohort of beneficiaries dropped significantly from 34.5% to 26%.

The lower 30-day readmission rates associated with alert services represents a potential savings of $2,179,000 in avoidable inpatient healthcare costs. The difference in readmission rates for patients when alerts were active is all the more dramatic given that providers subscribed to alerts for individuals at much higher risk for readmission. Compared to the overall population of Medicare fee for service beneficiaries in the Bronx who were never enrolled in alert services, enrollees in alert services were older, more ethnically diverse, more often dual eligible, and had significantly more comorbidities.