Smart Technology Reduces Unnecessary Emergency Department Admissions
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Safely avoiding emergency department (ED) admissions is a crucial strategy for increasing efficiency, conserving resources, and enhancing patient outcomes.
BURR RIDGE, IL, USA, June 16, 2024 /EINPresswire.com/ -- In the United States, approximately 30% of adult ED patients are admitted to the hospital, and three-quarters of all hospitalized patients originate from the ED. An emergency physician (EP) hospitalizes around six patients on each shift. However, safely discharging one of those cases instead of admitting them conserves about 80 hours of inpatient human resources, alleviates ED boarding, enhances overall ED throughput, and significantly improves hospital financial performance. Avoidable admissions are often observation status, which burdens patients with high co-payments and is a loss leader for hospitals. SmartContact™ by Auscura reduces these financial burdens, leading to a more sustainable economic future for hospitals.
SmartContact™ is a cutting-edge technology platform designed to bolster admission avoidance strategies in the ED. The solution provides data-driven insights, automated follow-up, and care coordination. This approach is vital, particularly given the increasing enrollment in Medicare Advantage, which emphasizes value-based care over volume-based care. In 2023, most Medicare enrollees chose Medicare Advantage, and the US government set a goal for 100% Medicare Advantage enrollment by 2030. Major insurers like Blue Cross, Humana, Cigna, Aetna, Anthem, and United Healthcare are expanding value-based payments, while companies like CVS, Walgreens, Amazon, and Walmart are exploring capitated healthcare models.
CASE STUDY
An analysis of a large suburban ED with an annual volume of approximately 80,000 visits provides valuable insights. The average admission rate was 30%, from 20% to 42%. The EP with the lowest admission rate ordered fewer advanced radiology studies, prescribed antibiotics and opiates less often, generated more RVUs per hour, and discharged patients faster. This case study demonstrates the potential benefits of implementing SmartContact™ in real life.
By implementing SmartContact™, the ED medical director identified the EP with the highest admission rate (Figure: blue line). The boundaries, represented by one standard deviation above and below the mean, were 35% and 26%, respectively (Figure: red/green lines). Through coaching and self-determination, the highest utilizer reduced his admission rate to the group average (Figure: gray line), demonstrating the solution's tangible benefits.
ADMISSION REDUCTION STRATEGIES
1. Standardize management and disposition practices for common conditions, such as low-risk chest pain cases.
2. Share monthly performance metrics to inform statistical outliers of their performance and motivate self-correction.
3. Encourage case managers to suggest alternatives to hospitalization, like skilled nursing facilities or intensive home care.
4. Have hospitalists evaluate ED patients to identify those suitable for immediate discharge.
5. Develop a model for automated wellbeing checks the day after ED discharge to address follow-up or medication management issues.
6. Review ED returns within three days and 30-day readmissions to identify patterns and areas for improvement.
7. Identify high ED utilizers, develop personalized care plans, and communicate with the assigned care team.
Hospitals can achieve significant financial, operational, and human resource benefits by leveraging performance metrics, encouraging informed patient decision-making, and utilizing innovative technology like SmartContact™. This approach addresses the nursing shortage and aligns with the broader shift towards value-based care, ensuring a viable, patient-centered healthcare system.
About Auscura
Auscura uses advanced automation and artificial intelligence to enhance value-based care delivery across various healthcare use cases. It enables organizations to transform complex data sets into actionable business intelligence reports.
Julie Danker, CXO
Auscura
julie.danker@auscura.com
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