Improving Care Coordination, Data Exchange with Direct Messaging

Direct secure messaging can help organizations improve data exchange, resulting in more comprehensive care coordination and smoother workflows.

Meaningful care coordination and more efficient clinical workflows depend on seamless data exchange between primary care providers, specialists, and their patients.

While much of the industry has struggled to create sufficient interoperability between disparate systems, Direct secure messaging offers a simple, low-cost way to share key patient data that supports chronic disease management and smoother transitions of care.

DirectTrust, a cross-industry collaboration that oversees the Direct messaging framework, connects more than half of the nation’s clinicians and enables successful health information exchange for thousands of care sites.

“Direct interoperable exchange of health care information throughout communities has been steadily increasing over the past few years, enabling significant enhancements to providers’ ability to impact safe, timely patient care,” said Holly Miller, MD, Chief Medical Officer at MedAllies and co-chair of the DirectTrust Clinician’s Steering Workgroup.

In a recently released series of case studies, DirectTrust explains how secure messaging can facilitate seamless communication among different organizations to enhance care coordination and provider workflows.

Improved referral and scheduling processes

Organizations can leverage Direct secure messaging to simplify patient referrals and appointment scheduling.

At Sutter Health in California, leaders created bi-directional, closed loop referral workflows, allowing providers to send referrals and receive information from consultants through Direct.

This resulted in higher staff and patient satisfaction, as well as quicker referral turnaround times and more efficient workflows.

Kno2, a company dedicated to increasing health data interoperability, also used Direct exchange to streamline provider workflows and the referral process.

Kno2 implemented Direct messaging so that PCPs and ophthalmologists could easily send and receive referrals for diabetic eye exams.

The organization also simplified the scheduling process for diabetic eye exams by switching from patient self-scheduling to scheduling by the ophthalmologist’s office.

Ophthalmologists were able to send exam results to PCPs through Direct. This change allowed PCPs to receive exam results within 48 hours, a significant improvement over the previous process in which PCPs received results only 35 percent of the time.

Direct also eliminated faxing between providers and reduced referral and scheduling times, leading to more efficient care delivery.

Enhanced data exchange between electronic health records

Organizations can leverage Direct messaging to promote data exchange between electronic health record systems at hospitals and primary care providers.

At Reliant Medical Group in the Boston area, leaders created a process that allows providers to automatically send patient summary documents to an emergency room EHR using Direct exchange.

Reliant also allows clinicians to relay event notifications from local hospitals by pushing Direct messages to home health agencies whenever a patient is seen in the ER or admitted to a hospital.

This system helps providers avoid unnecessary home health visits when a patient has been admitted to the hospital and allows for immediate home health follow-up once a patient has been discharged.

Additionally, Reliant has implemented an automated process that sends patient records to home health agencies whenever a shared patient is seen by a hospital provider. This allows home health nurses to access an up-to-date version of a patient’s treatment plan.

Circle Health, also in Massachusetts, similarly worked to improve health data interoperability and care coordination between hospitals and PCPs.

The Circle Health Hospital EHR sends real-time ADT (admit, discharge, transfer) notifications to EHRs at primary care providers using Direct messaging.

Upon receiving the ADT notification, PCPs send the patient’s latest progress note to the hospital, allowing hospital caregivers to deliver quality, coordinated care.

Communication gains between the VA and community health providers

The Department of Veterans Affairs (VA) implemented Direct messaging in three Ohio health systems to enable closed loop referrals with community providers, which has helped providers save time and resources

The VA also used Direct to simplify interoperability between the VA and Hospital Corporation of America (HCA) organizations.

HCA sends a daily census of VA members who have been admitted to the hospital. In response, the VA sends HCA the members’ medical records. Upon discharge, HCA uses Direct to send discharge documents to the VA to enable enhanced care management.

“The Direct interoperable technology is working,” said Miller. “However, these stories indicate that success requires strong leadership, change management and developing new workflows.”

“Implementations may require inter-organizational planning and communication. Our hope is that other communities will learn from the success of these organizations.”

Healthcare leaders that leverage Direct messaging and facilitate meaningful changes within their organizations can accomplish seamless communication and improved patient care.

“The success of Direct interoperability demonstrated by these provider organizations and HIT vendors shows how powerful this tool can be in solving some of our most basic interoperability challenges,” said Steven Lane, MD, Clinical Informatics Director of Privacy, Information Security, and Interoperability at Sutter Health.

“These are relatively simple solutions that can be implemented using any certified EHR. We hope to get the word out to clinicians across the country, so they can work with their clinics and hospitals to put this technology to work for their patients.”

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