February 21, 2018

Addressing High-Utilizers Starts in the ED

The majority of patients try to avoid the emergency department at all costs. Yet, for high-utilizing patients, the ED is often the easiest place to go for healthcare. Regardless of what you call them—high-utilizers, super-utilizers, or super users—the reality remains the same: the top 1% of patients account for 21% of healthcare spending, at an average of nearly $88,000 per patient annually.

We have previously addressed some of the strategies primary care providers can employ to find their high-utilizing patients. For emergency physicians, the challenge isn’t just identifying high-utilizers, it’s knowing what to do when they walk through the door.

Emergency Physicians at Capacity

Over the years, the number of patient visits to the emergency department in the US have steadily increased. The number of emergency departments themselves, however, have decreased, leaving fewer, yet busier emergency departments.

High-utilizers are commonly older, and often face chronic or comorbid conditions. Mental illness, substance abuse and social needs sometimes lie beneath the surface of presenting problems, exacerbating health issues. For many of these patients, the most convenient place to receive care is at their local emergency department. ED physicians are faced with the challenge of treating the patient with minimal context, which can lead to duplicative testing and wasted resources.

To cut down on spending and deliver the best care to super-users, emergency physicians have to consider the role they can play in administering effective and efficient care.

Real-Time Patient Data

Many emergency physicians have made great strides in coordinating care with PCPs and other members of the patient’s care team. Additionally, there are countless multidisciplinary initiatives and programs that have been tested and proven for turning high-utilizers into star patients.

The common denominator? Information sharing.

Emergency department staff should not have to piece together a patient puzzle; they should be handed a complete patient picture upon admission in order to immediately inform care decisions. Emergency physicians don’t just need more information, they need the right information. They need a patient’s story. 

At PatientPing, we’ve developed a platform that offers emergency department providers critical patient context to better inform care decisions and appropriate next steps in care. With this information, emergency physicians can easily see patient program attribution, the patient’s current and recent care team members, visit history, and care summary notes.

The Right Care is the Best Care

Of course, the ultimate goal for high-utilizers is to get them the most appropriate care. A study of 30 high-utilizers who had been directed to appropriate resources as opposed to acute care resulted in an 88% decrease in ED visits, as well as a drop in spend from $1.2 million to just $130,000.

With the right tools, emergency physicians can identify the true needs of high-utilizing patients, free up their resources, relieve emergency staff, and most importantly, ensure patients get the care that they need to stay out of the ED.

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Tagged: Care Coordination, healthcare, emergency department, Healthcare Providers, high-utilizers

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