State launches program to flag ‘high utilizers’ of hospital emergency departments

By: - July 31, 2018 6:17 pm

Dr. Bruce Lo sees these cases all the time, he said. A patient comes into his emergency department at Sentara Norfolk General Hospital, and they’ve already been to a different emergency room dozens of times in the past few months.

In the past, emergency physicians would essentially have to treat the patient in the dark, without much information from those previous visits other than what the patient says. But now, Lo can click a small icon in the electronic medical record and see the patient’s previous visits, the diagnosis and the care plan.

On June 30, Virginia launched its Emergency Department Care Coordination Program, which essentially connects every emergency department in the state. It means all emergency doctors like Lo can click the small icon on their screens, particularly to see if the patient is a “high utilizer,” meaning they visit the emergency department frequently.

The program has already made a difference for Lo, he said in an emailed statement. He identified one patient who had been to 10 other emergency departments in the past several months, and another who had had more than 80 visits over the past year. It let him directly address why they were visiting so often.

“Before, unless the patient divulges that they’ve been to another emergency department outside the health system, physicians didn’t have that information for visits outside their health system readily available,” said Lo, who is also the president of the Virginia College of Emergency Physicians.

During an event to announce the program Tuesday, Gov. Ralph Northam said it will help improve health care quality, access and cost by letting emergency departments communicate with each other, identify patients who may need additional care and eliminating wasteful test duplication.

“I think we all realize that if we don’t wrap our arms around the cost of health care it is what will take this commonwealth  and it is what will take this country to its knees,” said Northam, a pediatric neurologist.

Dr. Daniel Carey, Virginia’s secretary of Health and Human Resources, speaks during an event to announce the Virginia Emergency Care Coordination Program, which connects all emergency rooms across the state.

The program was established during the 2017 General Assembly session through legislation carried by Sen. Siobhan Dunnavant, R-Henrico, and John O’Bannon, a former Republican delegate from Henrico. Both Dunnavant and O’Bannon are doctors.

It cost $3.9 million for its first two years, with $3.5 million coming from federal funds secured from the Health Information Technology for Economic and Clinical Health Act.

The plan is to expand the care coordination program outside of emergency departments eventually to allow communication across other aspects of health care, including primary providers and community services board for behavioral health treatment.

“We are not finished here by any means,” said Debbie Condrey, chief information officer of the Virginia Department of Health, which is managing the program.

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Katie O'Connor
Katie O'Connor

Katie, a Manassas native, has covered health care, commercial real estate, law, agriculture and tourism for the Richmond Times-Dispatch, Richmond BizSense and the Northern Virginia Daily. Last year, she was named an Association of Health Care Journalists Regional Health Journalism Fellow, a program to aid journalists in making national health stories local and using data in their reporting. She is a graduate of the College of William and Mary, where she was executive editor of The Flat Hat, the college paper, and editor-in-chief of The Gallery, the college’s literary magazine.