THE CHALLENGE
Tampa General Hospital is one of the most advanced healthcare systems in the country with over 1,000 beds and 35 locations. It is also a top-ranking hospital being recognized by Becker’s as one of the “100 Great Hospitals”. And innovation plays a key role in their success. TGH has won no less than 7 “Most Wired Awards” from the American Hospital Association for technical excellence.
Frustrated with its ongoing need to manage an ever-changing community provider directory, reliance on fax to communicate, and needing a solution to meet new regulatory requirements about PCP notification at patient admission and discharge, TGH turned to careMESH.
“We were drawn to careMESH because they solve a key challenge: how to move all communications with external clinicians to digital communications.”
THE SOLUTION
With Go-Live in early June 2020 (at the height of the COVID-19 pandemic) careMESH integrated its Directory with TGH’s Epic® EHR, connected via an HL7 interface, and configured its platform to support the message content TGH wanted to share through Admission and Discharge notifications, Referrals and General Communications with community providers. TGH was then ready to use the embedded careMESH Directory from within Epic to find the providers they wanted to connect with and route all clinical communications to careMESH.
As part of implementation, the two organizations had contacted community partners that did not already accept communications through Direct Secure Messaging to invite them to pre-enroll in the program. careMESH also conducted outreach to show the practices how to manage clinical communications to align with their existing workflows. Some chose to have communications sent directly to physicians, some assigned delegates such as referral coordinators, others wanted to disseminate communications to different administrative groups, and some practices chose to have incoming communications forwarded via careMESH to Direct Addresses or e-Fax.
“Private practice partners are the lifeblood of our community, so we are eager to engage with them about mutual patients, proactively share notifications with embedded digital patient records, and offer them a chance to stay deeply involved at every step of the patient care journey.”
CUSTOMER IMPACT
Delivery Rate of >99%
Because of the comprehensive nature of the careMESH National Provider Directory, >99% of messages to outside providers from TGH have been delivered to the designated recipients since Go-Live. And at least 96% of those are delivered within 5 minutes. If contact information becomes out-of-date, careMESH Delivery Managers conduct research to ensure Admissions, Discharges, Referrals and other Transitions of Care are routed to the right person, at the right location.
Why not 100% Delivery? Every now and then we find that a provider has retired or permanently left their practice.
Rapid Increase in TGH Digital Delivery
A key program goal was to deliver a capability that would help connect community providers to the digital world. Previously, a majority did not use Direct Protocol mailboxes for Transitions of Care and that impacted TGH’s Promoting Interoperability Results. At the time of launch <14% of providers could receive CONNECT messaging using the Direct protocol. By pre-enrolling a number of large practices before Go-Live, quickly reached 21% on launch day, 57.1% at 90 days and then 79% after one year.
As one community provider told us: “I like receiving referrals by careMESH - it simplifies things”
Practice Adoption
Community physician and practice adoption began through an outreach effort before Go-Live, with ~200 providers activated on careMESH in the week prior to launch. Since then, each outbound message provides recipients with easy access to a rapid on-boarding process and patient record viewer built into the careMESH application.
REGULATORY COMPLIANCE
One of the drivers behind implementing careMESH was to ensure that TGH met Promoting Interoperability targets and complied with both the new CMS Conditions of Participation in Medicare and a Florida state regulation on Patient Access (FL 843).
By leveraging the careMESH National Provider Directory to identify a patient’s PCP at admission or discharge, an HL7 interface with Epic, and careMESH’s Delivery Manager, TGH can ensure full compliance with the regulations without needing any measurable changes to its EHR or to its clinical workflows.