NPO Case Study

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Michigan’s Northern Physicians Organization Partnered with eMedApps to Overcome Interoperability Challenges, Improve Care Coordination and Realize Previously Impossible Transitions of Care Revenue

eMedApps’ CareBridge™ interface engine unlocked and unified patient data held in nine disparate EHR systems. The solution incorporated a notification system to alert providers when their patients had hospital or ER visits and covered 90% of the beds in the state. The notifications provided an immediate risk stratification report via the ADT Quick Analytics ™ tool allowing for timely proactive follow up by providers, reduction in high Emergency Room utilization and improved patient-provider relations.

Goal

  • Break down EHR data silos to create a longitudinal record of care: Integrate data stored in disparate EHR systems allowing patient data access and sharing across practice and hospital boundaries. Create a comprehensive view of care history and the ability to better manage broader population health.

Action Plan | Result

  • Extracting patient-provider relationship files (ACRS files) from nine different EHR systems, eMedApps created a central hub of patient information synchronized monthly with the Michigan Health Information Network Shared Services (MiHIN). Once connected to NPO’s HIE, a complete view of the patient was created allowing patient matching with >85% accuracy.

Goal

  • Improve collaboration between providers, hospitals and patients: Quickly notify providers of patient hospital visits, allow providers and patients to better utilize and manage healthcare service choices, improve outcomes and care satisfaction, and reduce unnecessary ER visits.

Action Plan | Result

  • Collaboration between sending hospitals and NPO practices was central to the action plan. eMedApps’ CareBridge interface allowed the relay of real-time admit, discharge, or transfer (ADT) records from sending hospitals to NPO, alerting physicians that patients were recently seen in an area hospital. Currently NPO is receiving ADT messages for over 50 active practices Email notifications are sent to the primary care physicians by Direct Trust either into the EMR or to a designated account through the NPO HISP. The provider is alerted days before a discharge summary would normally be received from a hospital.

Goal

  • Improve patient care and reduce ER visits: Connect providers to patient information collected or stored outside the clinic walls allowing care intervention and improved patient care management that would reduce or avoid the need for additional ER visits.

Action Plan | Result

  • The continuing care conversation extends beyond the provider’s office. The NPO partnership with eMedApps brings social workers into the care conversation including utilization of services and promotion of deeper out-patient engagement and monitoring. Currently three Community Mental Health agencies (CMHs) are receiving notifications so social workers can identify and reduce the risk of treating drug-seeking patients.

CareBridge Flow Chart

Overall Program Results Post Deployment

  • Complete patient information is automatically curated and shared faster.
  • Patient satisfaction increased as well as confidence in care provided.
  • Patient tracking and management improved allowing practices to run more efficiently.
  • Meaningful Use quality measures met as post-discharge follow-up was improved.
  • Non-emergent use of ER decreased eliminating waste.
  • Greater sharing of patient records through networked HIEs and physician practices decreased duplication of unnecessary or redundant procedures.

About Northern Physicians Organization

Northern Physicians Organization is a physician-led group aligning doctors’ processes, communications, best practices and ideas since 1984. They work with over 520 physician members in Northern Michigan. Founded by local physicians, NPO enhances the practice experience by providing support, information and education to ensure that all practices run smoothly and efficiently.

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