Quality Health Network (QHN) of Grand Junction Colorado receives real time HL7 ADT messages for urgent care, emergency department, and inpatient stays. Providers are offered the option of receiving the messages for all of their patients or can subscribe to a specific group of patients, e.g., diabetics to support population health management. QHN supports multiple methods for notification delivery, e.g., Direct messaging, secure file transfer, or forwarding the ADT messages. This enables QHN to support variations in provider workflow. In the second quarter of 2015 QHN provided over 23,000 alerts to 38 participating practices.