Data Element

Comment

Standard interoperable handoff alerts would improve transitions

Care transitions are typically challenging and filled with opportunities for a decrement in care quality.  The ability to document and exchange special alerts related to transitions and handoffs of care would help close a current gap in health information interoperability.  The implementation of this data element should ideally be coordinated and harmonized with the Care Plan (https://www.healthit.gov/isa/taxonomy/term/7596/level-2) which is also currently a Level 2 data element. 

Special Alerts use case comment

Commenting from the lens of mostly the Beh. Health and post acute landscape, I can say this is a very well thought out and strong use case that is needed as part of a larger transitions of care workflow.  Special alerts would be beneficial in a multitude of care settings, but a few specific examples stick out that we see our clients utilize/manage daily.  Some potential positive outcomes that would come from this data element being adopted are as follows:

- better transitions of care between internal and external care teams, alerts that would focus on potentially dangerous or sensitive information should be at the forefront of any Transition of Care. 

- Specific examples we see on our side are with forensic behavioral health cases, where prisoners/detained individuals are ordered to visit psych. care in some capacity.  Special Alerts would keep the safety of the patient and care team first.  Substance abusers, violent histories are a few other examples of where having an active urgent alert present upon transition or handoff will be beneficial.

As mentioned above by Dr. Miller, the capturing of these data elements are nearly universal between EHR's but there is not much weight being placed on the categorization of the elements.  The Interoperability mechanisms are present as well and with communication between EHR's growing steadily, this use case is something that lends well to the overall Interoperability landscape.  Seamless transitions between workflows of the care providers, both internal and external, is crucial to keeping the level of care at it's highest and most beneficial to the patient.       

 

 

Data Element Information

Holly Miller, MD and Terrence O’Malley, MD have developed a set of data elements that fill the gaps between caregivers. These data elements allow a focus on longitudinal and holistic care. This has been accomplished by Drs Miller and O’Malley working with professional and technical workflow thought leaders and completes a person's chain of care. When examining the current EMR chain of data it is Person “Provider" Centric Care, not truly Person Centric. There are currently silos of EMR data that are beginning to be aggregated by IT vendors but are not focused in real life clinical/technological workflows. Multiple provider portals are not the answer. Person Centric Handoff Data Elements are essential in comorbidity requiring chronic care conditions making up a large percent of care, require holistic/longitudinal care documentation. Recognizing, coordinating, and documenting the required handoff care data elements are mandatory for Value Based Quality of care and clinical cost effective outcomes. Solutions like TEFCA are steps in the right direction, but the Special Alerts For Care Handoff Data elements have to be the guidelines and not boiling the ocean with irrelative data to a person's centric care.

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