A data-sharing initiative among emergency departments in Washington reduced ER visits by Medicaid patients by 10 percent in the program's first year, according to a report from the Washington State Health Care Authority.
It hasn't been a completely voluntary effort, reports Bloomberg Businessweek. After attemts to cap reimbursement for non-emergency visits to ERs led to outcries from providers, the state, hospitals, and physicians came together to create what they call their "Seven Best Practices"mainly that doctors need more information in the ER and afterward to provide the most effective care in the least-costly setting.
Starting in the summer of 2012, the state required hospitals to adopt a new database, Emergency Department Information Exchange, to track patients' ER visits.
"It also created a whole new set of data so hospitals and communities could look at what patients are coming back to our emergency rooms," Carol Wagner, senior vice president for patient safety at the Washington State Hospital Association, says in the article.
Among the findings from the first year:
- The rate of ER visits that resulted in non-acute diagnosis decreased more than 14 percent
- Prescription of narcotics for Medicaid patients in ERs fell by 24 percent
- Medicaid ER costs fell $33.7 million in the 2013 fiscal year, though with other changes implemented, it's not clear that was totally due to the database
Other states are considering enacting similar systems, especially as a means to thwart "doctor shopping" for narcotics.
Repeat visitors and pill takers were among the most common non-emergencies seen in ERs, according to a recent Slate article.
ER physicians are less likely to admit patients to the hospital when they have readily available electronic access to those patients' health records, concluded a study from Weill Cornell Medical College on use of a health information exchange.
To learn more:
- find the report (.pdf)
- read the article