Cutting Costs With Care Gap Alerts

But there are hurdles to adoption. "We deliver through a portal, and the provider usually prints the alerts. That's great if you have paper-based records. [But] providers with EHR systems ironically don't yet see the benefits of NaviNet's care gap alerts," says Weston.

There also needs to be more education among providers as to how to fit the alerts into their workflow, Weston says. Some who have already implemented EHR systems may ignore care gap alerts altogether because they have not yet been fully integrated." Integration with EHRs is a goal, says Weston. A software upgrade in June was a move toward integrating the care gap alerts with EHRs and health information exchanges. But widespread adoption hinges on an emerging set of standards coming from healthcare reform and Continuity of Care Document guidelines. CCD is an XML-based specification for sharing patient summary information electronically.

In the future, alerts could be ranked and displayed in hierarchies designed to optimize the narrowing of care gaps. In a geographical region where a breast cancer screening event is planned, for example, alerts for screenings may be given prominence in how they are displayed to providers. Underscoring both eligibility and an upcoming opportunity to deliver services may lead to a rise in the rate that care gaps are narrowed or eliminated.

And payers may have the option of generating additional types of alerts. The service-oriented design of the software architecture "allows for adding alerts very easily," says Miller. On the pharma side, for instance, alerts could notify providers of contraindications and duplicate therapies.