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Transitions of Care Go Digital

Scott Mace, for HealthLeaders Media, May 20, 2014

Healthcare leaders are finding value in Direct messaging, but transferring information remains a challenge.

This article appears in the May 2014 issue of HealthLeaders magazine.

Still too often in healthcare, transition of care information chases caregivers. Patients often don't possess it or fail to bring it with them to subsequent encounters. Unanswered phone calls pile up in voice mailboxes, and faxes sometimes fruitlessly pursue physicians and specialists moving from practice to practice. The burden imposed upon staff and doctors alike is widely cited as one of the reasons healthcare costs continue to rise and gaps in care persist.

But with many providers facing deadlines to implement meaningful use Stage 2 this year, and the availability of a series of technologies including the Direct protocol, that is starting to change.

"Prior to Direct, what was happening was the case manager in the hospital would make a phone call," says Laurene Vamprine, CIO of Erlanger Health System, a five-hospital health system with more than 800 beds in the Chattanooga, Tenn., region.

"It ends up being this phone tag thing, back and forth," Vamprine says. "With protected health information, you can't leave the information in voice mail. You can't send it through regular email, so it becomes difficult to actually go ahead and tell the other person what you need to have done on a specific patient."

In October 2012, Vamprine heard about a new form of health information exchange being adopted by a coalition of public agencies in southeast Tennessee that would employ the Direct protocol to connect acute care hospitals with health coaches.

"Instead of coaches having to go to the hospital to pick up discharge papers or wait for a fax to come from the hospital, it can be transmitted immediately and securely through email," says Thomas E. Preston, assistant director for the Southeast Tennessee Area Agency on Aging and Disability in Chattanooga. "Also, the same transmission can be sent to several different people or several different locations that have a Direct account at the same time, instead of sending out three different faxes to three different people at three different places."

Preston says the agency's health coaches are able to check their Direct mail from wherever they are—on their phone, laptop, or tablet, "not having to wait until they get back to the office to pick up a fax to do it."

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