COVID-19 ENS Smart Alert Communication to Members

Tuesday, March 24, 2020

Today HealthShare Exchange (HSX) will begin rolling out a COVID-19 smart alert as part of our Encounter Notification Service (ENS). You do not need to do anything to enroll in this new service. It will be activated for all current ENS users.

 

The notices about individual patients will appear differently based on how you use ENS and receive notices today. To the extent possible, we are trying to make this consistent with your existing workflow and how you currently use ENS.

1. ENShare
Two new filter options will be available:

a. Coronavirus – Diagnosis Code: Any patient notifications that match the three main diagnosis codes (U07.1, U07.2, B97.29 or B34.2) on or after March 1, 2020, will be displayed.


b. Coronavirus – Admit Reason:  Any patient notifications whose admit reason contains the words “covid” or “coronavirus” on or after March 1, 2020, will be displayed.

 

2. HTML via HSX Direct Webmail Platform
An additional subscription will be configured so you will receive an additional notification with “CORONAVIRUS ALERT” in the subject line for any discharged patients that have any one of the diagnosis codes listed above on a per patient basis.

3. SUMMARY FILES via HSX Direct Webmail Platform or SFTP
An additional subscription will be configured so you will receive an additional file each morning with “CORONAVIRUS NOTIFICATIONS” in the subject line for any discharged patients that have any one of the diagnosis codes listed above for the 24 hours prior. (Approx. delivery time –– 8:00 AM to 10:00 AM)

Notifications will be triggered by:

  • Encounters carrying any of these ICD-10 codes:
    • B97.29, Other coronavirus as cause of disease classified elsewhere
    • B34.2, Coronavirus infection, unspecified [While CDC recommended not using this code, as all sites are known to be respiratory, we are seeing it used in practice.]
    • UO7.1 and U07.2  (emergency codes in ICD-10 activated by WHO and now being worked into EMR coding libraries; U07.1 to mean lab-confirmed diagnosis and U07.2 to mean clinical diagnosis without lab confirmation)
  • Use of the text strings ‘COVID’ or ‘coronavirus’ in the visit reason, chief complaint, or diagnosis segments of incoming messages.  Note that free text, uncoded diagnoses may say things like “COVID-like symptoms” or “Test for coronavirus” and may not positively identify COVID-19.

Coding practices around COVID-19 are evolving rapidly, and you should not assume that all COVID-19 related notifications are definitive diagnoses of COVID-19. At our members’ suggestions, we are making the alert sensitive rather than specific. Therefore, we expect false positives among the notifications. The implementation of UO7.1 and U07.2 and incorporation of lab feeds, which we are fast-tracking, will help us refine the notifications over time.
 
At this time, we are not triggering notifications on Z20.828, Contact with and suspected exposure to other viral communicable diseases.
 
Initially, notifications will be triggered based on inpatient and emergency department encounters. We will evaluate adding notifications based on ambulatory encounters in the near future. For this reason, individuals diagnosed in the community who do not need hospital-level care will not trigger notifications at this time.
 
We value your feedback on this service, and we appreciate our members in the HSX community who have reached out to us at this challenging time to tell us how we can help you. To let us know how this service is working for you, to change how you receive COVID-19 notices, or to update your subscriptions, please contact: support@healthshareexchange.org.
We will do our best to accommodate you and help you keep your patients and staff safe.