Tracking treatments
By Sherri Buri McDonald, The Register-Guard, Eugene, Ore. | |
McClatchy-Tribune Information Services |
Iverson is a social work care manager in the emergency department at
She is the person who tries to help patients who show up frequently at the emergency department with needs that would be better met at a regular doctor's office, a county health clinic, or a community program, such as St. Vincent de Paul or
Iverson routinely creates customized care plans for these patients to try to steer them to other agencies and away from expensive emergency room treatment for problems that aren't medical emergencies.
Now, with the Emergency Department Information Exchange, or EDIE, those care plans can be shared with a growing network of emergency departments throughout
"It will be good," Iverson said, "because the information we put in care plans to help people not use the ER so much will go all over" -- to
Before EDIE, a hospital might be able to track frequent users of its own emergency department, but it had no way of knowing whether those same patients had been to other emergency departments in the area, said
For most hospitals, many of these repeat emergency room patients are a financial drain because they have minimal or no health insurance, and can't pay for the services.
Or, if they are covered by
Now with EDIE,
McKenzie-Willamette, owned by
As part of health care reform, which seeks to improve health and reduce costs through better coordination of medical services, EDIE "makes total sense," Herrmann said.
"I haven't seen or heard one push-back about this system at all from any key stakeholder," he added.
Small reduction, big savings
Since
But even a small reduction in ER visits could achieve big savings, he said.
"If we were just to decrease ER visits by 1 percent in
Patients who overuse emergency departments do so for a range of reasons.
The patient might have mental health or substance abuse problems, a lack of access to primary care, a lack of knowledge of where to get basic health care or a lack of housing, Herrmann said. Or the patient might be trying to get multiple prescriptions for narcotics, he said.
Among Washington Medicaid clients who were repeated users of emergency department services, 80 percent had mental health problems and 40 percent had substance abuse issues, according to a March report by the
Collective Medical Technologies claims that patients enrolled in EDIE on average have a sustained 60 percent reduction in emergency department visits in the first year of enrollment.
With EDIE, the emergency room doctor has more knowledge about the patient, said Keene, the company spokeswoman.
"The beauty of EDIE is, since we have these feeds set up with all of the hospitals in a region, we can notify hospitals of their patients' utilization regardless of whether it's at that individual hospital, or if they've been at 15 other hospitals," Keene said. "They can route them to a better care provider or can route them back to their primary care physician for prescriptions. ... The biggest driver (of reducing emergency department visits) is just that knowledge."
That has been the experience of
"The communications between emergency rooms has been incredibly beneficial providing consistency of care for patients and increasing the quality of care for patients," said
Program's beginnings
Collective Medical Technologies was founded in 2005 by two computer science majors at
Green's mom, a nurse at a
A few years later, the company got its first client -- a hospital in
Using EDIE with
The rate of emergency department visits per 1,000
Those figures caught the attention of the
Many businesses want health care costs curbed in order to stop the spiralling expense of health insurance premiums.
Starting in March with the Tuality hospitals in
Another 16 Oregon hospitals are planning to start using it by September, with all 59 Oregon hospitals expected to be on board by November, she said.
Collective Medical Technologies is working to expand into hospitals in
"If we can get all the hospitals along that
Benefit of collaboration
The cost of bringing EDIE to all
The hospitals also pay one-time set-up costs.
Collective Medical Technologies offers technology that can bring others onto the EDIE system, so a primary care doctor or health insurance plan, for example, could receive an EDIE alert when patients/members visit an emergency department on the EDIE network.
That could enable a primary care doctor to discuss a patient's condition with the emergency physician treating that patient, or a health plan to preauthorize expensive diagnostics for a patient in the emergency department.
"This allows us to start to coordinate care across the delivery system," VanPelt said.
"It's possible that we could do it with dentists, mental health and behavioral health; we haven't crossed that bridge, he said, adding that the system is voluntary in
Follow Sherri on Twitter @sburimcdonald . Email [email protected] .
EMERGENCIES
Annual visits to local emergency rooms
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