Healthcare Technology Blogs by Innovaccer

Exhausted ED Facilities: Why is Healthcare in a State of Emergency?

Where would you go for a treatment if you hurt your leg and need first aid? Now, what if it’s a backache? Or something which could be anything but an emergency? Stats say many patients prefer ED visits because they are either faster, or convenient, or both! Across the nation, Emergency Departments are themselves in a state of emergency, specifically, in a state of overutilization.

For a variety of reasons, EDs are treated like urgent care facilities. A literature review published in the American Journal of Managed Care found that nearly 37% of the annual ED visits are not critical and could have been treated in other less costly facilities.

Why are EDs the new favored center for treatment?

Undoubtedly, many patients go to the Emergency Departments on account of a bonafide emergency. However, there are many cases which could have been dealt with without getting and ED utilization. Many times in surveys patients have said that were not able to get quality care elsewhere because other facilities are not well-equipped as compared to Emergency Departments. Their perception about the ability of different facilities to treat them is something that results in excessive ED utilization in many cases.

The consistent failure of scheduling systems makes it impossible to get proper PCP appointment. Many patients are referred by hospital staff to go to an emergency room or they would have felt that it would take less time for the patient. The lack of access to primary care and convenience of “on-demand care” in ED facilities are one of the major contributors to unnecessary ED visits.

Patient Data— The magic bullet to reducing unnecessary ED visits

The growing importance of quality care has made it imperative that we plan and focus on delivering patient-centric care, and Emergency Departments can prove to be an unparalleled assistance in achieving this. The only concern regarding patients visiting EDs is their missing data.

Healthcare organizations are unable to identify the patients who are frequent flyers. Similar is the case with patients- they are unable to identify the severity of their ailment and end up in ED instead of any other facility such as urgent care or ambulatory care facility, where they should have gone in the first place.

Almost 14.7% of ED visits end in inpatient admissions. In fact, ED visits are among the primary sources of inpatient admissions, accounting for nearly half of the total inpatient admits. With proper data at the disposal, healthcare organizations can identify every patient visiting ED facility and can take necessary steps towards eliminating further chances of reoccurrence of such visits. Once they can get their hands on proper data, care teams can initiate efficient interventions to ensure that the patient need not go to any ED facility in the future.

4 E’s to unlock the mystery of ED overutilization

Reducing the overutilization of ED facilities is not Rocket Science. All it requires is a better understanding of the patient, ‘ready-to-leverage’ information, and better strategies to smartly engage with patients. Here are 4 E’s for reducing unnecessary ED utilization:

1.) Examine– Enabling providers to know their patients

It is not that providers don’t want to know their patients, but their inability to identify every patient is what the problem is. It is imperative that care teams and providers have proper data related to the patients in their network on a single data platform along with those who have visited ED facilities recently. The first step towards reducing the ED utilization is to identify the main utilizers of the facility. The search for main utilizers should start with the identification of frequent flyers— understanding their patient population and major drivers.

2.) Evaluate– Analyzing the hidden aspects of overutilization

Once we are able to identify the patients who are high utilizers of ED facilities, providers can analyze the reasons for their visit and can initiate necessary intervention based on the insights obtained. In order to segregate between the necessary and unnecessary ED visits, it is essential to analyze the visits based on the visit cause, treatment provided, referrals made, and post-treatment suggestions.

3.) Engage– Effectively connecting with patients

Once the care teams learn about their patients, they can create care plans that aim to treat patients and drive them towards preventive care. Care teams should engage with patients post discharge with frequent follow-ups to reduce the possibility of any sudden episode and suggest them cost-effective alternatives to EDs. Care managers can initiate follow-up programs with their patients through calls or texts based on the insights obtained about the patients. In this way, care teams can drive non-critical cases to other facilities such as urgent care facilities.

4.) Educate– Eliminating any chance of patient ending in the wrong care facility

Eventually, during the proper engagement with patients, care teams can ensure to educate them regarding their health conditions and future steps that they need to take. Providing them with proper information about the preventive measures that patients can take, care teams can reduce the unnecessary utilization of ED manifold.

Predictive analytics— An advanced step towards an efficient ED utilization

Predictive analytics can turn out to be a major weapon in dealing with improper ED utilization. With predictive analytics, providers can analyze the medical history, present health status, utilization patterns, and any other factor that might contribute to an emergency state for the patient.

Providers can stratify the patient population on the basis of their risk-scores and can learn how a patient might behave in the future based on their episode history, risk profiles, and medication adherence, and take preventive measures well in time. With point of care insights, physicians can gain the right information required for every patient right on their computer screen. Patients can be informed in time if they are at a risk of falling ill, or in the worst case, going to an Emergency Department.

Knocking on the future of smart care management

Whether it be unnecessary ED utilization or avoidable readmission to the hospital– it is not just the financial losses which matter, but also the patients who return home with a feeling that they have not been provided with apt care. It is more important now than ever before to start tapping on the patient-centric care approach of the care delivery. Reducing ED utilization might not be the answer to every question, but it is, definitely, the answer to many questions. As members of a progressive healthcare, we cannot leave any question unanswered.

To know more on how you can reduce your ED utilization rate with a unified healthcare data platform, get a demo.

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Join Team Innovaccer at 2018 Community Health Institute and Expo in Hyatt Regency Orlando, Orlando, FL at booth #921 on August 26 – 28, 2018.

Abhinav Shashank

Abhinav Shashank

Chief Executive Officer & Co-Founder - Innovaccer.

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