Clinician Resources

Alerts are secure Direct email notifications sent to healthcare organizations in near real-time when their patients are admitted to, discharged from, and/or transferred within a participating hospital or skilled nursing facility, or when they have had an ambulance visit.

Rhode Island Quality Institute (RIQI) sends three types of alert notifications, and consolidates them when applicable, to reduce duplicates and save time:

Facility-Identified Alerts

As of May 1, 2021, CMS is requiring hospitals to notify primary care providers and post-acute care providers when their patients are admitted to and/or discharged/transferred from their hospital with the goal of improving care transitions. Read the CMS Fact Sheet to learn more about CMS’ modification of Conditions of Participation (CoPs) requiring admission, discharge, and transfer event notifications.

RIQI sends these “Facility-Identified Alerts” on behalf of the following hospitals:

• Kent Hospital
• Women & Infants Hospital
• South County Hospital

Providers receive an alert from these hospitals when either or both of the following are true:

• Facility where patient is being treated sends provider’s Direct address to RIQI
• Facility where patient is being treated sends provider’s NPI # to RIQI, and RIQI locates a Direct address within NPPES.

Facility-Identified Alerts indicate whether the Direct address was provided by the facility, whether it was located in NPPES using an NPI # provided by the facility, or both.

 

CurrentCare Alerts

CurrentCare Alerts are sent when all of the following conditions are true:

• Patient is enrolled in CurrentCare
• Facility where patient is being treated sends the Primary Care Provider’s NPI # to RIQI
• Primary Care Provider enabled CurrentCare Alerts through RIQI and has provided a Direct email address

Care Management Alerts

Care Management Alerts are sent when all of the following conditions are true:

• Healthcare organization contracted with RIQI to receive Care Management Alerts
• Healthcare organization included patient on their panel/list of active members
• Healthcare organization provided a Direct email address to receive alerts for that member

TIP:  RIQI recommends that providers add/update their Direct address within their NPPES account as soon as possible, and where possible, communicate the Direct address to others (see FAQs below).

Sample Alert #1 – Facility-Identified Alert

This is an example of a Facility-Identified Alert, where Kent Hospital identified that this provider needs to receive this notification, either as a primary care provider or a post-acute care provider.

The alert explains how the Direct address was provided:

• Direct address provided by facility
• Direct address provided by NPPES **
• Direct address provided by facility & NPPES **

** The facility provided the NPI #, and RIQI found the Direct address in NPPES.

Sample Alert #2 – Facility-Identified Alert combined with Care Management Alert

This is an example of 2 alerts that have been combined to reduce duplicates:

Facility-Identified Alert: Kent Hospital identified that this provider needs to receive this notification, either as a primary care provider or a post-acute care provider.

Care Management Alert:  organization identified that this Direct address should receive alerts for this patient on their Care Management panel.

Which Data Sources are Included in RIQI Alerts?

Inpatient and Emergency encounters from the following Hospitals are included in Alerts:

 

Special Flags: Expired & Potential Overdose

When applicable, all alert types will contain flags that notify you of unique scenarios for that patient encounter:

Expired:  When a patient expires at the treating facility, we include that important information within the subject of that alert, so that healthcare teams are notified up front.

*Potential Overdose*:  Alerts indicate this flag when either or both of the following are true:

• the “Reason for Visit”contains a keyword such as: overdose (and other variations such as od, o.d., etc.), Narcan, drug ingestion or accidental poisoning
• an ICD10 “Diagnosis”code includes: “Poisoning by drugs, medicaments and biological substances” (with a few exceptions that aren’t overdose-related)

The “Potential Overdose” warning was developed with the intention of notifying recipients when there is a potential of an overdose. It is recommended that recipients use the information as a guide to identify alerts that might require further investigation.

FAQs

What triggers a Facility-Identified Alert?

As of May 1, 2021, CMS is requiring hospitals to notify primary care providers and post-acute care providers when their patients are admitted to and/or discharged/transferred from their hospital, with the goal of improving care transitions. Read the CMS Fact Sheet to learn more about the CMS Interoperability and Patient Access final rule.

Will the alerts include behavioral health hospitals or hospital units?

At this time, due to the Rhode Island state laws, information from these types of facilities will not be included in the Facility-Identified Alerts.

Will RIQI send Facility-Identified Alerts from all hospitals in Rhode Island?

RIQI has partnered with Care New England Hospitals (Kent and Woman & Infants) and with South County Hospital to send their required CMS notifications. For these hospitals, RIQI will also combine any other Alerts you may already receive as part of your ongoing partnership with RIQI – specifically, Care Management Alerts or CurrentCare Alerts.  All other hospitals in RI will send their own Facility-Identified Alerts to your Direct address.

I already receive Care Management Alerts and/or CurrentCare Alerts from RIQI, what will change?

Where possible, RIQI will combine these alerts with the Facility-Identified Alerts to minimize duplication to a particular Direct address.  For those hospitals that send their own alerts, you may see an alert from that facility and a separate Care Management and/or CurrentCare alert.

Is there anything that my organization should do to prepare for the Facility-Identified Alerts?

Because all the alert types – whether directly from a hospital or via RIQI – require the recipient to have a Direct email address, it is important to ensure that your Direct address is shared in the appropriate places.  RIQI recommends that you enter the Direct address for each provider at your organization into the national NPPES database (log in, go to ‘Provider’ & ‘HIE’).  It is also recommended that you communicate your Direct address to RIQI via your Care Management Panel, or via the CurrentCare Hospital Alerts form, as applicable.  This is especially important if you have changed practices or if your practice has been acquired/changed names, etc.

How do I get a Direct Account?

Because many EHR vendors provide the ability to host Direct email accounts, please check with your own vender for your organization.  You can also find more information at: DirectTrust.

I already receive Alerts from RIQI, will they look different than they do now?

RIQI has ‘standardized’ the heading of each alert so when we combine a Care Management or CurrentCare Alert along with a Facility-Identified Alert from CNE or SCH, you can understand why you are receiving the alert and can also tell which facility (hospital) generated the alert.  Please refer to the examples in this document.  For hospitals who will be sending their own alerts directly to you, their format may look different from RIQI’s format.

What should I do if I know my patient was in a hospital and I didn’t get an alert?

If you normally receive either Care Management or CurrentCare Alerts from RIQI, please contact us. If you do not have any agreements in place with RIQI to receive these alert types, please contact the hospital directly where your patient was admitted/discharged.

Resources:
Facility-Identified Alerts Compared to Existing Alerts and How to Share Direct Address (Video – 6 mins)

 

If you would like more information about Alerts, please contact RIQI at RIQIBusinessServices@riqi.org or 888.858.4815.