HIE can help identify ED 'frequent fliers' for care coordination

Data from a health information exchange can more accurately identify patients who visit hospital emergency departments frequently than a single site's records, according to research published at Health Affairs.

The study involved 10 hospitals in the New York City metropolitan area participating in the New York Clinical Health Information Exchange (NYCLIX), a regional HIE. The researchers looked for patients who visited an ED four or more times within 30 days during the study period.

The HIE data revealed 20.3 percent more frequent ED users and 16 percent more visits by them to the ED that site-specific records. It also found that 28.8 percent of frequent ED users visited multiple EDs during the 12-month study period, versus 3 percent of all ED users.

The researchers also found significant differences among frequent ED users: For instance, users were more likely to be male (51.1 percent versus 44.9 percent) and older (mean age of 40.7 years versus 37.9 years), and more of them had crossover visits (28.8 percent versus 3.0 percent).

The communitywide perspective more closely represents the patient's true experience, the authors noted.

"An improved ability to identify frequent ED users allows better targeting of case management and other services that can improve frequent ED users' health and reduce their use of costly emergency medical services," they wrote.

A second recent study published in the December Health Affairs debunked the notion of frequent emergency room patients as mentally ill substance abusers. The study, also of New York City ED patients, found they're more likely to have chronic conditions and visit primary care providers and specialists even more than the ED.

Oregon is claiming early success with a program using coordinated care to reduce ED visits by "frequent fliers." North Memorial Health System in Minnesota, meanwhile, is reducing visits by sending paramedics to patients' homes.

To learn more:
- here's the abstract