What is an ADT?
ADT stands for Admission, Discharge, Transfer. ADT messages are standardized, text-based data packets that communicate real-time updates as a patient moves through the healthcare system. Think of each ADT as a snapshot in time — unlike a consolidated clinical document (CCD), which aggregates a patient’s full history, an ADT captures a single event at the moment it occurs. If new information needs to be communicated, a new ADT is generated.
The three core events tracked are:
- Admission – a patient’s entry point into a service or encounter
- Transfer – a patient’s movement between programs, departments, or locations
- Discharge – a patient’s exit or closure from a service
Beyond these core events, ADT messages can be triggered by many other scenarios, such as updates to patient information, appointment or visit-type changes, and more. Technically, the HL7 standard that governs ADT messages defines over 50 message types, but the vast majority are not applicable to county behavioral health. Most ADTs received from third-party sources will fall into just 3–4 categories covering initial encounters and visit or appointment changes.
What Information Does an ADT Contain?
Each ADT message is organized into segments that can include:
- Message header – metadata such as the sending application, the receiving endpoint, and the date/time of the notification
- Trigger event – the specific event type that generated the message
- Patient demographics – core identifying information
- Visit details – information about the specific encounter
- Procedures, diagnoses, and insurance – clinical and coverage data, when present
- Care team members – individuals associated with the patient’s care
- Allergies – when included in the ADT
Not all fields will be populated in every ADT. The dashboard automatically hides unpopulated sections, but users can click Show All to view all available sections for a given message
Why Use the ADT Dashboard?
The ADT Dashboard enables real-time monitoring of a patient’s journey across healthcare systems. Its core purpose is to support care coordination by surfacing timely information that helps prevent gaps in care.
Key use cases include:
- Identifying when a client in your catchment area has had a hospital encounter, so you can follow up
- Monitoring specific clients you are actively coordinating care for
- Reviewing encounter histories for clients to inform care planning
- Identifying clients who may be in your catchment area but have not yet been seen in your SmartCare instance, and determining whether outreach is warranted
CalMHSA Connex receives ADTs from multiple external sources, including Sac Valley MedShare, Kaiser Permanente, and Manifest MedEx, in addition to both your county and other county’s SmartCare instances. This means the dashboard will surface events that occur both inside and outside of your own organization’s system.
ADT Volume – What to Expect
ADT volume can be high. Multiple ADTs may be generated for the same client on the same day, as each discrete event triggers its own message. For example, creating a client record, enrolling them in a program, transferring them, and then discharging them would each generate a separate ADT.
This is by design — the system is tracking each point in the patient’s care journey — but it means users should anticipate some noise and develop internal workflows for how to manage it. Considerations include:
- Who on your team is responsible for reviewing the dashboard, and how often
- What filters are most useful for your county’s work (by date range, county, facility, visit type, or specific patient)
- Which clients you want to actively track by importing them into your Patients & Clients list (see Notifications section below)
Access Controls
Access to the ADT dashboard requires several prerequisites:
- PA Amendment – Your county must have signed the ADT Dashboard PA amendment.
- Training – Users must complete training before being granted access to the ADT Dashboard
- County Authorization – Users must be designated by their county’s Connex representative. Attendance at training alone does not grant access; county authorization is required.
For initial onboarding, counties can submit a spreadsheet of all users needing access. After onboarding, additional users can be requested via a help desk ticket.
Once authorized, new users will receive an email from [email protected] with sign-in instructions. Existing Connex users who are being granted ADT dashboard access will receive an email notification when their access has been upgraded.
Notifications
The ADT dashboard delivers notifications both in-app (via a notification drawer within Connex) and via email. Email notifications do not contain PHI — they include only the ADT event type, date, time, and location, along with a link to log into Connex to view the full details.
Who Receives Notifications?
Specific alert notifications are tied to individual users based on two criteria:
- Care team membership – If a user is listed as a care team member for a client in SmartCare and has ADT Dashboard access in Connex, they will receive notifications when an ADT is generated for that client. Both conditions must be true — care team membership alone, without ADT dashboard access, will not result in a notification.
- Patient import – If a user with ADT Dashboard access has manually imported a client into their Patients & Clients tab in Connex, they will receive ADT notifications for that client. Removing a client from the Patients & Clients screen (clearing them) will stop specific notifications for that client, though that client’s ADTs will still appear in the broader dashboard view.
All users with ADT Dashboard access can view ADTs in the dashboard for any client in their county’s catchment area (based on the Medi-Cal Member Eligibility File, or MMEF) and for clients within their county’s SmartCare instance. Specific notifications are an additional layer for clients you are actively tracking.
Managing Notifications
Within the notification drawer, users can:
- Archive notifications they no longer need
- Mark notifications as unread or pin them for follow-up
- Filter by unread or flagged messages
- Perform bulk actions (archive, pin, or mark as unread) across multiple notifications at once