Orlando Health is a $3.8 billion, not-for-profit, community-based network of hospitals, physician practices and outpatient care centers across Central Florida. The organization is home to the area’s only Level One Trauma Centers for adults and pediatrics and is a statutory teaching hospital system that offers both specialty and community hospitals.

THE PROBLEM

Enacted on July 1, 2019, HB-843 is a new Florida law that requires notifications of patients’ primary care physicians within 24 hours following hospital admission. The new law also requires that the discharge summary and medical records be provided to the primary care physician within 14 days after the patient’s discharge from the hospital. It also provides for patients to request a hospital treating physician to consult with their primary care physician or specialist provider.

Major health systems like Orlando Health have scrambled to implement new workflows and technologies to enable mobile care team collaboration with community physicians and extend the reach of their electronic health records as now required by Florida law.

"Orlando Health is focused on improving customer, patient and provider engagement and improving the overall quality of care through care team collaboration."

Dr. Joshua Briscoe, Orlando Health

“Like every hospital, we are always looking for ways to improve provider-to-provider communication, patient engagement and the customer experience,” said Dr. Joshua Briscoe, medical director of IT innovation, virtual care and clinical information at Orlando Health. “When new regulations became law with Florida House Bill 843, it became the catalyst to making further improvements.”

The primary goal of the legislation was to enact real-time notifications between providers at the point of patient care to prevent hospital readmissions and unnecessary or redundant diagnostic tests like CT-scans and MRIs, he explained.

PROPOSAL

Orlando Health looked into health IT from vendor Andor Health, which it is in the process of implementing. The system enables automated two-way communication and consults between the inpatient care team and PCPs, regardless of their credentialed status. It is designed to eliminate manual processes currently in place including faxes, phone calls and searching for provider contact information by automating the delivery of hospital admission, discharge and clinical care summaries.

“The ThinkAndor solution implements a bidirectional link between the inpatient care team and PCPs and sends messages directly to patients inquiring about their preference for PCP consultation, eliminating the manual administrative work required to send patients’ provider consult requests, and hospital admission, discharge and clinical care summaries to PCPs,” Briscoe explained. “With the implementation, we will be 100% compliant and able to facilitate timely information sharing with clinicians inside and outside of Orlando Health.”

Additionally, the system will integrate with Orlando Health’s electronic health record system in parallel with the organization’s phased transition to a new comprehensive health record system over the next year, he added.

MARKETPLACE

There is a variety of care coordination health IT vendors on the market today, including Ensocare, eQHealth, Greenway Health, GSI Health, Imprivata, Optum, pMD and VitalHealth Software.

MEETING THE CHALLENGE

Primary care doctors spend approximately two hours on administrative tasks and regulatory requirements for every hour spent in direct patient care, contributing to high rates of burnout, according to research.

“The solution implements a bidirectional link between the inpatient care team and the in-state or out-of-state PCP,” Briscoe said. “It will completely eliminate all the manual researching of provider information and fit in naturally with their clinical workflow – without inundating physicians with EHR alerts or requiring them to perform administrative tasks outside of direct patient care.”

Leveraging artificial intelligence and natural language processing technology, the system identifies keywords and other critical health content in physicians’ conversations and automatically recommends notes and triggers that can be added to patient charts following a provider consult call or other communication.

“The solution automates all of the very manual and time-consuming steps that a physician has to take to respond to notifications and alerts and reach out to PCPs,” he noted. “It takes care of everything automatically, eliminating the extra work, waste and inefficiencies while meeting all of the requirements in the legislation with a 100% compliance guarantee.”

The new system will unlock data from the EHR and put it to use in real time to enable care team collaboration, inside and outside of Orlando Health. The system will search for identifying patient demographics and PCP information in the EHR or registration systems, as well as through a National Provider Identifier registry lookup.

From there, the system also can pull data regarding the inpatient managing physician to enable communication with the PCP, and Orlando Health will implement a bidirectional link if the patient has an acute status.

“With real-time communication between the inpatient care team and PCPs, clinicians can treat patients more efficiently and appropriately, reducing unnecessary or redundant diagnostic tests,” Briscoe predicted. “ThinkAndor also allows physicians to customize the alerts they receive, how and when they receive them, leading to reduced alert fatigue and burnout.”

RESULTS

“Although we have yet to go live, physicians are particularly excited about this initiative because it institutes a more efficient process,” Briscoe reported. “They are recognizing this as a shift in the right direction for health IT.”

The new system will demonstrate that workflows should drive technology, not the other way around, he added.

“It is yet another way we are achieving our objectives by increasing provider satisfaction and effectiveness,” he said. “Over time, we anticipate lower rates of psychological and physical burnout among Orlando Health affiliated physicians.”

Briscoe also expects the new system to help avoid costly penalties for non-compliance with new state regulations; improve provider satisfaction, loyalty and recruitment measures; and increase patient satisfaction measures.

ADVICE FOR OTHERS

“For Orlando Health, it was imperative to get out in front of the new regulatory requirements before any penalties were imposed, but we wanted to choose a technology solution that wouldn’t just guarantee compliance with the House bill,” Briscoe explained. “Rather, we wanted to ensure that the technology in the hands of the physician and care team wouldn’t be cumbersome and wouldn’t require additional work that would take the focus off providing care, simultaneously benefiting the overall patient experience.”

In the end, Orlando Health wanted a system that carried value well past the new legislation, and a tool that it was able to build upon, he advised.

“Orlando Health is focused on improving customer, patient and provider engagement and improving the overall quality of care through care team collaboration,” he concluded. “We’re taking aim at quality scores and other key measures like increased provider and patient satisfaction scores, reduced readmissions rates, and closing gaps in care.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
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