Better than Smoke Signals: A Digital Approach to Florida HB 843


By Justin Sims

September 19, 2019 — On June 25th, the State of Florida passed a new healthcare reform bill entitled “Patient Access to Primary Care Providers” or FL HB 843. It focuses on ensuring that a patient's primary care provider (PCP) is notified when the patient is admitted or discharged from the hospital and giving the PCP the opportunity to be consulted in the development of the patient’s care plan. The goal is clear: to ensure better continuity of care and collaboration between the hospital and primary care settings with the goal of improving patient outcomes. 


The new law doesn’t dictate how the notifications and patient records should be sent or how the care plan should be developed.  Hospitals can meet the objectives through fax, phone calls, carrier pigeon or smoke signals—it’s up to them. But not surprisingly, forward-thinking Florida hospitals are seeking technical solutions because smoke signals are rather inefficient and the alternatives are likely to add significant burden to already overworked administrative and clinical support teams.


Contrast this approach with the CMS Promoting Interoperability (Meaningful Use) program.  

For many years, CMS has provided incentives and/or penalties (A.K.A. the “carrot and stick” approach) to prompt hospitals to send transitions of care digitally. This has proven to be difficult for providers to achieve, and by one estimate, only about 30% of discharges result in a transition of care being “ordered” and those are often for long-term or specialty care—leaving the PCP in the dark. Moreover, if a digital transition does take place, it is often a singular alert with a subset of the patient record and generally lacks two-way communication or true collaboration.

This is not to say that the Florida law is better than the Federal regulations.  In fact, the two are highly complementary. One establishes the requirement for care team collaboration for all patients and all hospital encounters.  And the other encourages this to take place electronically. Florida seems to have gotten it right by laying out a strategy that brings state and federal law together.  

The challenge is how to scale these new digital notification requirements without placing a burden on staff, while leveraging existing infrastructure, and without a heavy IT lift.  This is where careMESH comes in. Using the only available HL7 FHIR©-based National Provider Directory as the foundation, careMESH securely delivers enhanced Admit and Discharge (ADT) notifications with patient records attached, to any PCP in the country—and does so digitally.  And, with only lightweight EHR integration that keeps users in existing workflows, you’ll never need to send smoke signals again. 

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