Hospitals should prepare now for the new Conditions of Participation

The New CMS Condition of Participation Requires Hospitals to Share E-Notifications

What does this new rule mean for hospitals?

On March 9, 2020, CMS announced new Admit, Discharge, and Transfer (ADT) Electronic Notifications Conditions of Participation¹ that left many questioning what the hospitals would be responsible for and what they would need to do in order to become compliant by the May 1, 2021 deadline. 

Here is a quick summary of the rule and a compliance checklist to help!

The new CMS Condition of Participation requires all hospitals, psychiatric hospitals, and critical access hospitals utilizing an electronic medical records system or other electronic administrative systems, (which is conformant with the content exchange standard HL7 v2.5.1) to make a reasonable effort to send real-time electronic notifications:

• At the point of inpatient and observation admission, discharge, transfer and at emergency department presentation or discharge
• To every patient’s established Primary Care Provider (PCP), established primary care practice group or entity, other practitioners/practice groups/entities identified by the patient as primarily responsible for his or her care, and applicable post-acute providers who need to receive notification for treatment, care coordination, or quality improvement purposes
• Containing at a minimum: patient name, treating practitioner name, and sending institution name

CHIE Alerts: The Simplest, Most Comprehensive Solution to Guarantee Electronic Patient Event Notifications are Processed in a Secure and Compliant Manner

Built on UHIN’s trusted network, CHIE Alerts alleviates a hospital’s compliance IT and data-sharing burdens. CHIE Alerts seamlessly delivers ADT e-notifications to providers in a patient’s care continuum, as well as to other requesting community groups. The CHIE manages all the complexities involved with sending the alerts, from executing data sharing agreements with all e-notification recipients, to managing and executing the frequent, real-time changes to a diverse array of patient roster types to track patient/provider attribution. Learn more about our CHIE Alerts suite at https://uhin.org/alerts.

Ready to get set up with CHIE Alerts? Contact our team today to Get Started.

Sources:

¹  CMS Interoperability and Patient Access final rule. 17 Jul. 2020. Accessed 9 Dec. 2020.  https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index

Dr. Don Rucker presented at the 2020 HIT Conference in his capacity as the National Coordinator for Health IT at the ONC. To view the video recording of the entire session, please click here.

Highlights from Dr. Rucker:

The pandemic has brought national awareness of the need for accessible, actionable health information. As the healthcare industry looks forward to possible solutions, the role of HIEs looks to be paramount on the road to interoperability. The ONC expects HIEs and data sharing agreements to grow with strong support and incentives from the federal level.

The ONC interoperability rule is an effort to achieve the goals of the CURES Act, which contains three major directives that affect the health IT sphere. They are as follows:

• Prohibitions against information blocking
• A requirement for application programming interfaces “without special effort”
• Creation of a common framework for HIE information exchange (HIE to HIE)

To read more about the interoperability rule and information blocking, click here.

“We believe the ONC interoperability rule is a very pro-public initiative,” said Dr. Rucker when speaking of the project. Elements like the introduction of a data standard built for population analysis rather than individual queries is meant to help healthcare providers gain the flexibility and capability to get more actionable information on their patient population and improve the quality of care.

The Q&A portion of Dr. Rucker’s presentation included questions on the HIT Certification Program, the current timeline on the interoperability rule, telehealth data standardization, and more. To skip directly to the Q&A video recording, please click here.