PCPs often lack access to Admit, Discharge and Transfer data

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Hospitals must do a better job of sharing Admit, Discharge and Transfer data with primary care physicians, who often are not informed by medical facilities when their patients have been hospitalized or discharged.

That’s the contention of Sean Cavanaugh, chief administrative and performance officer for tech start-up Aledade and a former official at the Centers for Medicare and Medicaid Services.

“One of the frustrating things for us has been hospitals that aren’t willing to notify our PCPs when patients have been discharged from the hospital,” Cavanaugh testified on Thursday before the House Ways and Means subcommittee on health.

According to Cavanaugh, PCPs who know when a patient is admitted or discharged from the hospital are better able to connect with patients during care transitions, which results in higher rates of medication adherence, lower rates of hospital readmission and better health outcomes.

However, he told lawmakers that hospitals will not often share ADT data with PCPs for business reasons; facilities see the information as a “competitive edge” and, in other cases, they are “unwilling to make even the minimal investments on the technology side to make this change.”

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Health information exchanges can help to facilitate real-time information sharing of ADT data, so that PCPs receive electronic notifications when their patients are hospitalized or discharged. “In some locations, there isn’t a health information exchange, and we reach out to a hospital directly and say we’ll tap into your system for our data. It’s appalling to me that some hospitals say, ‘No, we see that data as a competitive advantage, and we’re not going to share it with you,’ ” Cavanaugh added.

Aledade, which is led by CEO and co-founder Farzad Mostashari, MD, former National Coordinator for Health IT, partners with independent PCPs to create and run accountable care organizations. In his testimony, Cavanaugh said Aledade has successfully built a link between its ACO and a hospital in 30 minutes after agreements on business and policy issues have been reached by the parties.

“We have reached an inflection point with ADT data,” he told the health subcommittee. “It is time for sharing facility notifications with physicians for common patients to no longer be considered an aspirational goal, but a quality and safety requirement. We believe that it should become part of the Medicare conditions of participation.”

Cavanaugh concluded that he was encouraged by the fact that CMS last week released a request for information to obtain stakeholder feedback on ways to better achieve interoperability and to improve the sharing of healthcare data between providers.

He said the RFI “seemed to indicate that they were entertaining the idea that sharing information about hospital discharges and ED visits would be a condition of participation in Medicare.” Cavanaugh pointed out that 95 percent of U.S. hospitals have certified electronic health records. “They can do this—it’s all a question of will and whether they’re willing to put the beneficiaries first.”

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