The Truven Health Blog

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By Truven Staff

Lowering ED Visits — How to Redirect Consumers to the Right Site

Linda MacCracken imageThe demand for the Emergency Department (ED) is likely to climb and surge even further with the population gaining insurance under the Affordable Care Act. With more than 65 percent of current ED visits presenting as urgent (not emergent) visits, the anticipated demand surge from newly insured individuals will exacerbate the existing problem of patients using one of the most expensive care sites in our system.

What an opportunity! An opportunity to engage ED super-users and redirect them to better sites for their care. An opportunity to engage consumers pre-ED visit and integrate them to other sites of care. An opportunity to introduce Emerging Care to non-emergent sites of care. To find out how big the opportunity might be, we priced out a proposal made in a Health Affairs article to redirect 20 percent of ED visits to other sites of care — it created a national savings of B annually. How much could we save locally and how would we go about it? The following lists some of the solutions I’ve seen — which I offer for consideration to the healthcare community, in the call for redirecting consumers to the right care site, at the right time, for the right reason: 

  • Redirect Super-Users: Direct personalized messaging about the right sites to use for any individuals with 5+ visits/year.
  • Let ‘em come — on a schedule: Face it. Some consumers love the ED. Love the assurance of the best trained doctors taking care of the scary stuff. Let them book appointments at the ED clinic.  
  • Learn to Self Manage: For those with risk factors — send them personalized ED-prevention care messages to remind them to take care of themselves.  
  • Call v. Show Up for the Curiously Considering: Nurse- or extender-staffed call /live chat lines to discuss impulse driven reasons for the ED to take preventive steps.
  • Next time — to the Doctor: Employ a discharge patient coach who schedules patients into physician practices or the federally qualified community health center.
  • Open Door to the Fast Track: Provide mobile applications showing wait times and a way to reserve time for the walk-in patients.
  • Send Them to the Store: Since 85 percent of retail users have primary care providers (PCPs), I wonder how many of them split their time in EDs? Optimize the experience between PCP and ED for primary care, planned, urgent, and emergent care. 

Linda MacCracken
Vice President