1.2 The Need for a Standard

Event Notifications can be communicated via Direct today, however, there is not a universally accepted standard for messaging and terminology as of this publication.

It is critical that the recipient of an Event Notification via Direct can differentiate a notification from another type of Direct Secure Message (i.e. Transition of Care) because Recipient Systems may wish to route messages to a different department or automate workflows based on such information.

If a provider is a member of a care team, they may have interest in being made aware of a given patient’s arrival in the emergency department, or of a hospital or other facility admission.

Notifications may also be of interest as a patient progresses through various levels of care from the emergency department to the floor to intensive care or to a step-down unit. A provider’s interest in these events may vary depending on the role they have in the care team and the event that occurs. For example, knowing about admissions and discharges could be very important to a Primary Care and less important to a specialist treating an unrelated chronic issue.

Organizations that are at risk for provision of care such as traditional payers and provider organizations in value-based payment models may have a desire to understand when these events take place in order to manage compliance and to control costs. Timely information on inpatient discharges for example is critical in the process of initiating care management processes to prevent readmissions that negatively impact patient care and may trigger reimbursement penalties for organizations responsible for prior inpatient encounters.

The expectation for this IG is that Unsolicited Notifications as defined below will align with the HL7 ADT Trigger code set. This does not mean that events beyond this scope are not of future interest.