ER is For Emergencies Results in Better Care Coordination and Cost Savings
Emergency Department Information Exchange (EDIE)
- A group is available in EDIE that lists all patients that have visited your ED in the last month that have met or exceeded five ED visits in the last twelve months. The group is available in the Referrals & Groups section and is titled “5 in 12 Population.”
- A Care Guidelines template is also available in EDIE. The template was developed by clinicians from across the state and is located in the Care Guidelines section on each Patient Screen in EDIE.
Seven Best Practices Program
The goal of the Seven Best Practices program is to redirect care to the most appropriate setting, reduce low acuity, and reduce preventable Medicaid emergency room visits. The plan, which attempts to address the root of the problem—chronic medical conditions, substance abuse issues, and lack of primary care access—focuses on high users and will:
- Track emergency department visits to reduce “ED shopping”;
- Implement patient education efforts to re-direct care to the most appropriate setting;
- Institute an extensive case management program to reduce inappropriate emergency department utilization by frequent users;
- Reduce inappropriate ED visits by collaborative use of prompt (72 hour) visits to primary care physicians and improving access to care;
- Implement narcotic guidelines;
- Track data on patients prescribed controlled substances by widespread participation in the state’s Prescription Monitoring Program (PMP); and
- Track progress of the plan to make sure steps are working.
See below for one-page document outlining Seven Best Practices. Our success will work to prevent the state from enacting payment cuts to both hospitals and physicians for emergency room services.
Getting Started:
Seven Best Practices – Schlicher, Anderson, Neven
Managing Difficult Conversations – Anderson
How Payors can Contribute – Thompson
EDIE demonstration screen – Rudberg
Health Integration Project: Emergency Department Navigation in Oregon – Henderson
- WSMA video: Reducing Preventable ER Visits (30:50)
- WSMA video: Reducing Preventable Emergency Room Visits (5:25)
| Best Practice | Goal |
| A) Electronic Health Information | Exchange patient information among emergency departments |
| B) Patient Education (Translated into multiple languages.) | Help patients understand and use appropriate sources of care |
| C) Patient Review and Coordination (PRC) Information | Ensure hospitals know when they are treating a PRC patient and treat accordingly |
| D) Patient Care Plans | Assist clients with their care plans |
| E) Narcotic guidelines | Reduce drug-seeking and drug-dispensing to frequent ER users |
| F) Prescription Monitoring | Ensure coordination of prescription drug prescribing practices |
Resources:
Policy: Care Management in the ED (Sample Policy)
Background information on Medicaid Emergency Department Use
Implementing Emergency Room Best Practices
Letter to HCA and legislators regarding non-emergent conditions
