Preventing Unnecessary Readmissions Program to Include Free and Low Income Medical Clinics Treating the Uninsured in Trinity’s Nine-County Region
East Tennessee Health Information Network (etHIN) was recently awarded a Trinity Health Foundation Phase II Small Grant for its Preventing Unnecessary Hospital Readmissions Through Provider Alerting program.
Under the program, etHIN will implement an automated, HIPAA-compliant email alerting service to inform healthcare providers in free and low-income medical clinics and rural health departments of their patients’ hospital visits. These alerts will allow the clinic providers to contact patients to schedule follow-up visits, ensuring greater compliance with medications and treatment plans prescribed during hospital visits. The Trinity grant will enable etHIN to implement and provide the service to the clinics at no charge for the first year.
The program will benefit uninsured persons in Trinity Health Foundation’s nine county service area and can potentially reduce the number of 30-day hospital readmissions due to proactive care coordination by the providers. The overall number of visits to the hospital emergency department may also be reduced as a result of a trust relationship being built with the patient during the provider outreach. Proactive outreach enhances the doctor-patient relationship and can encourage the patient to rely more heavily on the clinic as their preferred primary care location. Regular primary care visits ensure better patient compliance with treatment plans, especially for chronic diseases such as Type 2 Diabetes and COPD, potentially reducing hospital visits related to those conditions.
etHIN will also provide clinical portal access at no charge for one year to each of the clinics that participates in the secure email alerting program. The etHIN clinical portal provides a cross-community view of the patient’s medical records, provided by etHIN participants, which will allow the clinics to have a much more in-depth understanding of the patient’s medical history. Having immediate access to historical medical records can help the clinic providers better understand the patient’s needs, allowing them to provide additional preventative care which can also improve health and help reduce hospital readmissions.
Trinity Health Foundation’s service area includes Knox, Anderson, Blount, Grainger, Jefferson, Loudon, Roane, Sevier, and Union counites. Several free and low-income clinics serving the uninsured population in those counties have expressed an interest in participating in the program, which is expected to launch in early 2019.