Written by: Center for Care Innovations


Develop an automated email alert (called “ProACT”) to patient-centered medical home staff regarding patient ED or inpatient care transitions.


Patients in or discharged from the ED or hospital.

Project Highlights

Design innovation techniques engaged stakeholders to frame the most pressing problems and explore solutions. The innovation identified barriers and means to improve post–ED/post–IP discharge care coordination and communication among patient-centered medical home care team members. Physicians and staff preferred automated email notifications, including patient identifiers, medical home/primary care provider information, and relevant clinical documentation, to improve communication efficiency. The team also identified Care Managers as the primary users of the automated email notification system.

Evidence of Cultural Change from the Innovation Process

Innovation design techniques are now used in routine performance improvement activities in employee health services (for better access to request appointments), managed care services (for addressing gaps in cervical cancer and breast cancer screening), improving access to certain types of surgery, and improving TB detection rates.


ProACT Adoption Guide