September 2016

Welcome to 
WISHIN Connections , the monthly e-Newsletter from the Wisconsin Statewide Health Information Network (WISHIN).  We will keep you up to date with WISHIN activities, news on health information exchange (HIE) and new product developments.
Have a WISHIN story you'd like to share? Let us know. 
Medicaid Prescription Data Now in WISHIN Pulse
Medicaid prescription-fill data for Wisconsin Medicaid members is now included in WISHIN Pulse, the statewide community health record. Medicaid prescription-fill history dating back to May 1, 2015, has been loaded into WISHIN Pulse and the data is being refreshed twice daily from the Medicaid pharmacy claims system, thus providing near-real-time prescription information to support better informed patient care and safety for Medicaid patients.

"We are constantly adding new participants and data sources to WISHIN Pulse to provide value to our participants and the patients they serve," says Joe Kachelski, CEO of WISHIN. The addition of Medicaid prescription-fill data substantially enhances the clinical data available through WISHIN Pulse.

"With hundreds of thousands of Wisconsinites covered by Medicaid, the addition of up-to-date prescription information is going to add substantially to the value of WISHIN Pulse."

Providers using the WISHIN Pulse system will be able to view Medicaid prescriptions in a tab under the "medications" section. WISHIN Pulse also includes information such as diagnoses, immunizations, lab results, care plans, and visit summaries.  In addition, WISHIN Pulse has integrated with the state's Prescription Drug Monitoring Program (PDMP) to allow clinicians to see a patient's history of controlled-substance prescriptions without having to log on to the state's system and separately search for a patient.

WISHIN Pulse users should be aware that the data displayed represents the vast majority of drugs paid for by Medicaid. However, it possible that in the transmission process a small number of records may fail to immediately load.  It is also possible that prescription-drug claims may be reversed after appearing in WISHIN Pulse.   

WISHIN User Tip:
Forgotten Password

For security reasons, WISHIN cannot unlock user accounts. 

If you forget your password or get locked out of your WISHIN Pulse account, your organization's IT help desk can help you get your password reset. 

If you're not sure who to call at your organization, you can contact WISHIN support at wishin.support@wishin.org or call (608) 235-4245 and we can provide you with the correct contact.
Improving Care Management with the WISHIN Patient Activity Report
In many cases, Medicaid health plans and other payers are not aware of their members' Emergency Department (ED) or other hospital admits or discharges unless they make arrangements individually with each hospital to get notifications or until the claim resulting from the visit is received, which may take up to 30 days. 

The Patient Activity Report for Payers (PAR-P) provides daily notifications of patient hospital or ED visits to payers. The report, which includes admission, discharge and transfer (ADT) information, was created to help payers follow up proactively and timely with members who have visited a hospital or ED. The PAR-P can help to assure compliance with care plans, avoid preventable re-admissions, prevent duplicative testing and procedures and connect targeted Medicaid ED visitors with medical homes or appropriate follow-up care.

Working in Partnership for Improved Care Coordination

The PAR-P project was developed by the WISHIN team with input from payers and completed in partnership with and supported by funding from the Wisconsin Department of Health Services (DHS). The first sites, Medicaid health plans serving certain members in Milwaukee, went live in April 2015. Many of the health plans chose to include members beyond those in the pilot population.

In September 2015 a survey was distributed to the pilot sites to gather feedback on the organizations' experiences with PAR-P and what they would like to see in Phase 2.

More than 80% of respondents indicated that they found the PAR report useful and timely. When asked how the patient care coordination process changed with information from the report one respondent commented that the follow-up process has been made easier by having the most recent demographic information on a patient. The respondent continued,

"It also allows us better access to patients that have been floundering in the system without access to a [primary care physician (PCP)] due to their own lack of knowledge. The hospital inpatient notification has allowed us to share this information with their PCP and obtain referrals to our care coordination team for temporary or permanent placement into a care coordination or disease management program. These patients in the past were typically lost until they presented to an office and at that point their disease may have progressed needlessly."

Phase 2 Improvements
 
By the request of the pilot sites, the PAR is now delivered to an sFTP folder rather than via secure email. The sFTP folder process can simplify health plans' workflows so that their systems can automatically retrieve the file from the folder rather than taking multiple steps to open secure emails and download the files.

Additional Phase 2 improvements were made to provide more details to payers receiving the report to clearly indicate what event triggered the PAR. For example, event identifiers were added to encounters including whether the notification is being sent because of an admission, discharge or change in demographics, or change in diagnoses. Furthermore, five new data elements have been added to PAR-P: event type, discharge date & time, discharge disposition, internal visit/account numbers and the primary-care physician. With the addition of these details, case managers can quickly move through their workflow rather than spending time identifying why the report was generated or tracking down contact and other information critical to a swift follow-up.

WISHIN is pleased about the potential of the PAR-P report to connect health plans and their members to accelerate and improve care. The addition of the PAR-P to WISHIN's services builds on its mission to promote and improve the health of all communities and patients in Wisconsin. 

If you have questions about the PAR-P's capabilities and uses or would like to find out if your organization could use the report, contact WISHIN at wishin@wishin.org or (608)274-1820.

It's National Health IT Week!

In this collaborative forum public and private healthcare constituents work in partnership to educate industry and policy stakeholders on the value of health IT for the U.S. healthcare system. With Meaningful Use now providing the way forward, there is no better time for the health IT community to come together under one umbrella to raise national awareness!

Learn More
HIE News
Wisconsin Statewide Health Information Network | Company | (608) 274-1820 | wishin@wishin.org | www.wishin.org | PO Box 259038 | Madison, WI 53725-9038
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