Association for Public Policy Analysis & Management

Research Objective: The Encounter Notification Service, or ENS, is an admission, discharge, transfer (ADT) alert program that was implemented in August 2012. The objective of this study is to describe the use of ENS during the first two years of operation. As of November 2015, all 48 acute care hospitals in Maryland and 6 hospitals in Washington, D.C. could provide ENS notifications to subscribing care entities. The objective of this report is to examine (1) the demographics of patients for whom notifications have been sent, (2) the alert preferences of care entities that have subscribed to ENS, and (3) the characteristics of the ENS notifications that have been sent during the study period.

Study Design: The data for this report was provided through Audacious Inquiry and includes information about ENS notifications from October 2013 through November 2015. The data includes more than 9 million notifications and information regarding 565 health care entities. This descriptive study looks at trends in notifications over time.

Population Studied: The population includes individuals who received care from a hospital in Maryland or Washington D.C. during the study period and for whom an ENS notification was sent. The report also examines the characteristics of health organizations that have subscribed to receive ENS notifications for their patients.

Principal Findings: In terms of the distribution of ENS notifications, the majority (40%) were sent to an insurance organization, followed by ambulatory care providers (20%), managed care organizations (10%), hospitals (10%) and FQHCs (9%). Most of the ENS subscribing organizations preferred to receive notifications on a daily basis and for care activities such as inpatient and emergency admission and discharge, as well as emergency registration. About 74% of notifications were sent for Emergency events with 26% sent for Inpatient hospital events. Among Maryland patients, 57% of notifications were sent for patients in the Baltimore Region, followed by 21% for patients in Suburban Washington, with the remaining notifications for patients from Eastern Shore, Southern and Western Maryland.

Conclusions: This report finds that ENS notifications are received by a wide range of care organizations throughout the state of Maryland and in Washington, D.C. including a large number of health insurers and managed care organizations. In addition to a variety of outpatient care providers; health service organizations such as addiction treatment centers and mental health providers have subscribed to ENS indicating the value of ENS alerts for providers outside of the primary care setting. Looking at notifications over time, it is clear that ENS has been adopted at a growing rate throughout the study period.

Implications for Policy or Practice: The findings of this report demonstrate that a wide variety of health organizations have adopted ENS and notifications are sent for patients throughout the various regions of Maryland. Given that both outpatient care providers and other health service organizations are utilizing notifications, ENS has the potential to serve as an important care coordination trigger and can improve the flow of patient information among different care entities.