To maintain their Medicare eligibility, hospitals with electronic health record systems will have to start sending notifications to doctors when a patient is discharged, according to a proposed rule that is part of a larger interoperability effort.
The CMS said in its proposed rule that the goal is to get more hospitals to notify doctors when a patient is discharged in an attempt to improve care coordination. The rule includes other provisions such as moves to discourage information-blocking by hospitals and insurance plans.
"Electronic patient notifications are a proven tool for improving transitions of care between settings and improving patient safety," the CMS said in a summary of the rule. "While deploying these notifications is low-cost and easy to achieve with any electronic health record system, many hospitals have not developed capabilities to send these notifications to other providers and facilities to whom they transition patients."
However, the rule gives hospitals latitude to be exempted from the requirement if their health IT systems aren't up to the task. The requirement would not apply to a hospital that doesn't have an electronic health record system with the capacity to generate the basic patient personal or demographic information for patient notifications.
The notifications would need to be sent "at admission and either immediately prior to or at the same time of the patient's discharge or transfer to licensed and qualified practitioners," and would include what treatment the patient received.
"Electronic patient-event notifications from hospitals, or clinical-event notifications, are one type of health information exchange intervention that has been increasingly recognized as an effective and scalable tool for improving care coordination across settings, especially for patients at discharge," the rule said.
The CMS doesn't believe the rule will create additional costs for hospitals. "The cost of implementing these proposed changes would largely be limited to the one-time cost related to initial implementation of the notification system, and to the revision of (any) policies and procedures as they relate to discharge planning," the proposed rule said.
CMS Administrator Seema Verma said that the rule would go into effect in 2020, and she downplayed any financial impact on hospitals.
"From an overall perspective we think this can lead to reduced costs because you are reducing duplication of tests, and more coordinated care will lead to higher quality and better health outcomes," she told reporters Monday.
But hospitals believe the requirement goes too far.
"We believe that CMS already has better levers to ensure the exchange of appropriate health information for patients," the American Hospital Association said in a statement.
