RD161 - Annual Report: Emergency Department Care Coordination (EDCC) Program Year 4 (November 1, 2019-October 31, 2020)

Executive Summary:

The 2017 Virginia General Assembly established the Emergency Department Care Coordination (EDCC) Program (§ 32.1-372 of the Code of Virginia) within the Virginia Department of Health (VDH) to provide a technology solution that connects all hospitals operating emergency departments (EDs) in the Commonwealth of Virginia. This was to facilitate real-time communication and collaboration among physicians, other healthcare providers and clinical and care management personnel for patients receiving services in hospital EDs to improve the quality of patient care services. The budget language in support of the legislation required VDH and the Department of Medical Assistance Services (DMAS) to obtain Health Information Technology for Economic and Clinical Health (HITECH) Act general funds for receipt of matching funds. In fiscal year 2018, VDH leveraged the $3.9 million funding budget to contract with ConnectVirginia HIE (CVHIE) to fulfill the legislative requirements of the EDCC Program. Collective Medical (CM) was later chosen as the EDCC Program technology vendor. ConnectVirginia and Virginia Health Information (VHI) completed a statutory merger, and effective July 1, 2019, ConnectVirginia is now a program of VHI.

Since implementing the Collective Medical technology in Virginia, emergency departments and health plans throughout the Commonwealth can share and receive real-time patient visit information directly in their electronic health record (EHR) or existing workflows. Real-time, actionable notifications, triggered by analytics, notify providers when a patient presents to the ED with complex needs. Most Virginia EDs receive standard alert criteria, and, as of October 2019, about 22% of patients on average triggered an Emergency Department information exchange (Edie) alert. The number of patients who trigger an EDie alert, or notification, has increased over time as the use of the program has grown and two new triggers were added to combat the opioid crisis. The number of visits which triggered an Edie alert averaged 70,037 per month in calendar year 2020 as of November 2020.

The patients who trigger an alert are considered most at risk for an avoidable encounter in the future and often have chronic conditions that have gone untreated and unmanaged. The Collective Platform provides notifications and a shared platform through which multiple providers can engage with that patient and collaborate on their care. The ultimate goal of the EDCC Program is to support the providers caring for these patients, to ensure that they receive the right care, with the right provider and at the right time.