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October 2014
Welcome to WISHIN Connections, the monthly e-Newsletter from the Wisconsin Statewide Health Information Network (WISHIN).  We will keep you up to date with WISHIN activities, news on health information exchange (HIE) and new product developments.

WISHIN Pulse Dashboard
Pulse Customer Statistics
# of Pulse Customer Sites:
      875
 
# of WI Counties w/Pulse Customers:                                
60
 

 
Pulse Transaction Statistics
ADT Transactions:
21,445,482
 
Lab/Pathology Reports:
6,671,545
 
Radiology Reports:
11,549
 
Transcribed Reports:
44,608
 
Public Health Syndromic Surveillance:
28,213,262
Pulse Patient Statistics
# of unique patients:
1,121,037
 
# of patients opted out:
29
 
# of patients opted back in:
1
   
Pulse User Statistics
# of Pulse Users:
355

 

 

WISHIN and Wisconsin Department of Health Services Kick Off Patient Activity Report Project
WISHIN kicked off a joint project on October 17 with the Wisconsin Department of Health Services (DHS) to promptly notify Medicaid health management organizations (HMOs) when their members have had a hospital encounter. Care managers at the participating HMOs will receive a report with information about their members' hospital encounters so they can do timely care coordination with the patient care team. This report is called the Patient Activity Report for payers, or PAR-P.

 

Currently, Medicaid HMOs and other payers may not become aware of their members' emergency department (ED) or other hospital visits until they receive the claim resulting from the visit - which can be up to 30 days after the event.  During this time, patients may have had even more hospital or ED visits.  The PAR-P is intended to help decrease the number of avoidable ED visits and related hospitalizations, decrease the number of duplicative emergency room and hospital tests and procedures, enable better care coordination, and connect targeted Medicaid and uninsured ED visitors with medical homes.
 

The PAR-P will be piloted with HMOs and populations selected by DHS. DHS' selection criteria included Medicaid HMOs in the Milwaukee area that are currently serving SSI members, with preference to HMOs expressing an interest in the Medicaid Complex Care Management Project.  Timelines for the pilot extend into 2015, and will depend on the pilot participants' cooperation. 
 

After the initial pilot, the PAR-P will be available to other HMOs for care management of their members.
 

The basic process for creating the PAR-P is outlined below, and illustrated in the diagram.

  1. HMOs will provide a list of members (enrollment files) to WISHIN.
     
  2. WISHIN will match hospital encounters submitted to WISHIN Pulse with the member demographics listed in the enrollment file.  If the insurance indicated in the encounter records match the HMO and the encounter was within the past 24 hours, a general description of the encounter will be added to the PAR-P.
     
  3. WISHIN will package the PAR-P and it send securely to the HMOs care management team for follow-up.

HMOs interested in receiving the PAR-P that are not included in the pilot should contact WISHIN at 608-268-1841 to be added as soon as the pilot completes.


 

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Wisconsin Statewide Health Information Network | 608-274-1820 wishin@wishin.org | http://www.wishin.org
PO Box 259038
Madison, WI 53725-9038

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