Real Time Alert System: A Disease Management System Leveraging Health Information Exchange

Vibha Anand, Meena E Sheley, Shawn Xu, Stephen M Downs


Background: Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools.
Methods: Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS)that is able to deliver alerts to PCPs for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA’s performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state.
Results: Our results show that RTA was successfully able to deliver “just in time” patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. Of those who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care.
Conclusions: We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCP despite lack of a link with their electronic health record (EHR). We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient’s asthma related emergency room (ER) admission so further follow up can happen in real or almost real time.

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Online Journal of Public Health Informatics * ISSN 1947-2579 *