The 2017 Virginia General Assembly established the Emergency Department Care Coordination (EDCC) Program (§ 32.1-372) 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. The program is meant 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 and general funds for receipt of matching funds.

Since implementing the event notification service (ENS) 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. All Virginia EDs receive standard alert criteria, and, as of October 2022, about 22% of patients triggered an Emergency Department information exchange (EDie) alert. The number of patients who trigger an EDie alert has increased over time as the use of the program has grown and three new triggers were added to combat the opioid crisis and COVID-19 pandemic. The number of visits which triggered an EDie alert averaged 94,150 per month in calendar year 2022 as of November 2022.

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/or unmanaged as illustrated in Figure 1. The Collective Platform provides notifications and a shared platform through which multiple providers can engage with that patient and collaborate on their care. The 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.