ACA Database: HIE Enrollment Requirements

By THCBist

Frank writes:

I hope someone can help me understand the requirements for HIE enrollments.

I’m on the front line at a hospital as a patient advocate charged with enrolling admitted patients into the portal.  I get very little information from Administration or the Informatics office.  I know there is a financial incentive for the hospital to enroll patients and have them open one of their charts in the portal.  Initially, we were told in January 2015 that we needed to enroll five percent of our admitted patients bySeptember 30 and enough extra to account for the five percent we would have enrolled in October, November, and December of 2014, had we been involved in the program.  Given that information, we started doing it and we were told how many people we needed per day to meet the final goal.  Several of us have been doing this, mostly on a daily basis and we believe we have met the requirements to date.  Now, Informatics tells us we need to enroll almost 1000 people in August and September.

We’ve been told by hospital officials we need to get the five percent only from admitted patients and we’ve been told by other hospital officials that we can enroll patients in observation status.  I’ve seen things in the CMS information explaining the numerators and denominators that says you work with patients admitted from the ED.  We’ve enrolled many patients admitted directly after surgery who never came through the ED.  I’ve also seen things that say the hospital can pick one three-month period for FY 2015 instead of using data from the whole year.  No one in Administration or Informatics at my hospital will answer these questions for me.

Are there any easy answers?  Do we enroll five percent of all admitted patients for the fiscal year if we are in stage 2?  Do we enroll five percent of all admitted and observation patients?  Do observation patients count?  Do surgery patients count?  Do we enroll as much as we can in a three-month period and then that figure is extrapolated to correspond with five percent of all patients for the twelve-month period?

I want to do this right for both the hospital and the patient, but I feel like we are spinning our wheels.  I also feel that if we need a huge push for the last two months of the government’s fiscal year 2015, then much of what I did from January through July must have been for nothing.  Does anyone have any insight?