Where is a person receiving care? Who is providing that care? What clinical or payment program is the individual in?
Knowing where an individual has received care or other services is perhaps the minimum necessary information for quickly assessing history. Knowing the care model (clinical and payment) provides the parameters for next steps. While this is a limited amount of information, it can be critical for taking action in a timely manner. It provides a key overview of relationships and supports many payment models. It is a core tool for care coordination and care management.
Updates include change in status, care provider or location, as well updates to descriptive information
- Registration
- Demographics
- Admit or Discharge
- Appointment
- Prescription Fill
- Plan Enrollment
- Program Attribution
A Notification Service
- Receives updates from entities with relationships to the individual
- Matches the individual in the update with known individuals
- Enforces privacy rules
- Maintains current and historical information on individual, entities and programs
- Maintains the current and historical linkages between individuals and organizational entities
- Maintains the current and historical linkages between individuals and programs
- Sends notifications of updates to entities with relationships to the individual
The core data include
- Individual Demographics
- Entity Demographics (the organization, for example, provider or payor, that is interacting with the individual
- Program Definition (the "program" that the individual is in, could be a clinical program or a payment program)
- The Individual-to-Entity Relationship
- The Individual-to-Program Relationship
This article from October 2016 describes notification services. Notification Service for Care Coordination in Value-Based Payment Models.
