From Alert to Action: How LANES Turned ADT Notifications into Dramatic Drops in ED Visits

When health information exchange (HIE) works, it is not just about data moving faster, it is about making data matter in the moment. That is what LANES and Northeast Valley Health Corporation (NEVHC) proved when they put real-time admission, discharge, and transfer (ADT) alerts to work.

The payoff? For patients with diabetes, emergency department visits dropped by 85 percent and hospitalizations fell by 68 percent. For asthma patients, ED visits plummeted by 82 percent. (CHCF) These are not incremental gains. They are seismic shifts in how care is coordinated and delivered.

What LANES Did Differently

Too often, ADT alerts are treated like a noisy notification feed. They ping, they pile up, and they rarely shape frontline care. LANES and NEVHC flipped that script.

• Workflow over inbox: Alerts flowed directly into NEVHC’s NextGen EHR workflow, not into a separate system where they would be ignored.

• Huddles with teeth: NEVHC teams reviewed alerts in weekly meetings, assigned follow-up, and shared back outcome data.

• Roster-driven care: Patients were matched against disease registries so alerts pointed to actionable populations, not just random encounters.

The lesson? Real interoperability is not about more data. It is about data that changes what the care team does before the patient slips through the cracks.

Why This Works: It Is All About Workflow

The impressive outcomes were not achieved because LANES simply “turned on alerts.” They happened because the use case was stakeholder-driven and built around workflow.

• Targeted alerts: LANES and NEVHC focused on disease-specific patient panels where the impact was likely to be greatest.

• Defined actions: Each alert came with a playbook — schedule a transitional care call, review medications, assign a coordinator.

• Shared ownership: Huddles and standing meetings ensured nurses, physicians, and care managers had accountability for follow-up.

• Feedback loops: Staff saw the direct impact of their outreach in the reduced ED visits, which reinforced adoption and built momentum.

The result is that alerts did not just move through the system, they moved people to act.

National Proof Points: UHIN’s Success with Alerts

LANES is not the only HIE proving that workflow discipline turns alerts into outcomes. Across the Rockies, Utah’s UHIN (Utah Health Information Network) has also delivered impressive results with their CHIE Alerts.

• At Granger Medical Clinic, embedding UHIN’s alerts into transitional care workflows reduced readmission rates from 23 percent to 9 percent.

• UHIN expanded alerts beyond hospital discharges, incorporating labs and pharmacy data that help providers close care gaps.

• Their alerting service is configurable, letting clinics define what really matters for their patient populations and avoid alert fatigue.

The lesson is consistent. When alerts are relevant, timely, and embedded into daily workflows, care teams are more effective and patients stay connected to care.

The Next Frontier: Crisis Episode Alerts

If ADT alerts can curb ED visits for chronic conditions, imagine what they could do in a behavioral health crisis. Importantly, crisis events do not need to be flagged by diagnostic codes alone. That would be too narrow and too slow.

Instead, HIEs could:

• Flag by source: Encounters originating in ED psych units, sobering centers, or crisis stabilization facilities.

• Flag by department: Events logged through EMS, mobile crisis lines, or law enforcement handoffs.

• Flag by workflow triggers: Discharge records that include behavioral health or substance use referrals.

These approaches lower the lift for HIEs and make crisis episode alerts more practical and scalable.

Break the Glass: Establishing Care in the Moment

Emergency access, often called “break the glass,” is not just a compliance feature. It is a way to establish a care relationship in the exact moment of crisis.

Consider two scenarios:

• A patient arrives in the ED unconscious after an overdose. The treating physician has no prior relationship with the patient. By breaking the glass, they can access medication history, known providers, and prior encounters in time to make safe decisions.

• A mobile crisis team responds to a 911 diversion. They have never met the individual, but break-the-glass access allows them to see if the person already has a behavioral health provider. That knowledge changes the response from “starting fresh” to “continuing the care path.”

In both examples, break-the-glass is not just about bypassing restrictions. It is about creating a documented, trusted relationship in real time when one does not yet exist. That is essential for last mile interoperability.

Converge POV: Making Alerts Work at the Last Mile

To replicate the success of LANES and UHIN, Converge recommends five essentials:

1. Start with rosters, not firehoses: Focus alerts on patient panels where the impact is highest.

2. Tie alerts to action: Each type of alert should map to a specific next step.

3. Expand beyond medical events: Build in crisis encounters and community-based touchpoints.

4. Support emergency access: Break-the-glass must be included from the start.

5. Measure relentlessly: Track outreach, reduced utilization, and improved outcomes.

Closing Thought

LANES and UHIN prove that HIEs can be more than data utilities. They can be engines of measurable improvement, cutting unnecessary utilization and improving patient outcomes. The next frontier is expanding that same approach to crisis care, where the stakes are even higher.

At Converge, we believe alerts are not just notifications. They are lifelines.