New Mexico cuts readmissions, improves ED care with middleware that enables information sharing

Beth Landon-policy director for the New Mexico Hospital Association

New Mexico is a state rich in history and natural resources. It also has one of the highest proportions of Medicaid beneficiaries, currently 42 percent of the population. Many of these patients live below the poverty line, struggle to receive adequate primary-care services and are high utilizers of emergency departments that in the past, did not have all the information they could have on their patients, especially from episodes of care at other facilities.

It was this perfect storm that lead the state's healthcare leaders to actively pursue positive change. Beth Landon, policy director for the New Mexico Hospital Association, said New Mexico's story is a success story, albeit a constantly evolving one, about how to change care delivery in the ED for the better.

"That doesn't mean it's poor quality today. It means that the information that is pushed to clinicians into their workflow improves the care they are able to provide and the handoff they are able to provide," she said.

Benjamin Zaniello, MD, chief medical officer for Collective Medical Technologies, added that the "most complex patients, the safety net population and uninsured and medicaid are really bearing the brunt of this fragmentation."

The success story includes collaboration and cooperation, with stakeholders regularly "gathering around the table," including health plan leaders. It also includes a piece of middleware technology that dramatically improved the accessibility of crucial patient information for ED physicians.

The evolution of their success is something Landon and Zaniello will share at an upcoming education session at HIMSS19 in Orlando.

Everyone who uses this tool actually gets value from it, Zaniello said, and that is key to it's willing adoption and ultimate success. Health plans are getting insight into patient activity for their membership. ED docs get vital information at the point of care that shifts their practice from medical uncertainty to medical necessity. The tech is not a healthcare information exchange by definition. It pulls the ADTCs from all participating hospitals in the state and then sorts the data that is most relevant for an ED clinician. Each hospital can modify what information they receive and then it is pushed to them either via a pre-programmed fax machine or it is integrated in their EMR.

"In emergency department care, ready access and workflow integration are everything. ED docs don't want to have to spelunk in their own EMR for additional information and they can't given their workload," Zaniello said. "They want it right there in front of them and that's how we provide it."

It's made a big impact on ED workflow and the quality of care, since doctors can now have more informed conversations with their patients and deliver more effective care. It's one technology that has been readily embraced, Landon said.

"There has been zero pushback from our health systems about sharing data with their neighbors down the street on this topic," Landon said. "It is a win for everyone and the ED physicians love it."

Landon and Zaniello will offer more insights at HIMSS19 in a session titled "New Mexico Reduces Avoidable ED Visits with Technology." It's scheduled for Thursday, February 14, from 4:00-5:00 p.m. in room W206A.

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com