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Tag Archives: emergency

Life-Saving Information: Only a Smart Phone Away

For people suffering with chronic medical conditions such as diabetes, allergies, or epilepsy, wearing jewelry or carrying wallet cards containing emergency medical information (EMI) can be life-saving. However, some people feel uncomfortable with the stigma attached to EMI, or don’t use such accessories due to cost or inconvenience. Children, especially, are not likely to carry EMI identification because they are often with caregivers who know their medical history and needs.

Linda Barlow

Linda Barlow

Despite these barriers, EMI is vital in emergencies. It can help people identify what is wrong, allow providers to give appropriate medical care, provide the necessary contact information for the patient’s physician and family, and improve time to treatment. But if EMI isn’t available or accessible, it won’t provide these benefits.

Endocrinologists at the Children’s Hospital at Montefiore have studied this problem and a potential solution: a smartphone app that can be accessed without knowing the person’s password. Since most people — including kids and teens — carry their mobile phones with them all the time, a smartphone app can circumvent the problem of someone forgetting to carry their traditional EMI. And since it is simply part of their phone, it avoids the discomfort some people have about wearing EMI jewelry.

A report on this new way of sharing EMI, published in the journal Clinical Pediatrics, reviews the current choices for EMI, as well as its usage and barriers, and introduces a new EMI option for Apple mobile devices.

“A cell phone maintains anonymity of a person’s medical condition unless an emergency requires accessing the EMI,” suggest the report’s authors, noting that medical alert jewelry is more obvious. “Another advantage of cell phone-based EMI is the lack of additional cost for a MedicAlert device and membership or similar service.”

One of the traditional barriers to using smartphone apps for EMI is the need to enter the user’s password to access the app, which isn’t always possible during an emergency. However, Apple’s new iOS 8 software for iPhones and iPads has an application called “Health” that allows a user to enter information that can be accessed from the home screen, even on protected phones.

By opening the Health app and selecting the Medical ID option, patients can provide their medical conditions, medications, allergies, emergency contacts, blood type, organ donor status, and DNR requests. The information can be accessed on a locked home screen by tapping the emergency button and selecting the Medical ID option. On screens without a password lock, the user can access the information by opening the Health application.

“Cell phone-based EMI should be embraced by patients, health care providers, and cell phone programmers,” the authors write. “It remains to be determined whether patients will use technology-based EMI once they are aware of the option. Medical providers, including first responders, should be aware of this technology to educate their patients and to access the information in emergency settings.”

“We are embarking on an education campaign to spread awareness about traditional and modern EMI options,” says Kristina Derrick, MD, MSc, Pediatric Endocrine Fellow, Children’s Hospital at Montefiore. “To start, we are creating information sheets that have instructions on obtaining EMI for the smart phone and traditional forms like jewelry and wallet cards. We will be distributing this information to patients, families and pediatricians as well as to emergency department staff and first responders.”

“Some patients may not be convinced of the need to have emergency medical information accessible to others,” Dr. Derrick cautions. “But even a patient or parent who knows everything about the medical condition and contact numbers may not be able to recall or relay this information during an emergency incident.”

Have you or a loved one used a smartphone based EMI to share important medical information with providers? Or is this a technology you would consider using? Let us know in the comments section.

Our Top 4 Most ‘Liked’ Health Care Stories

This week is Real World Health Care’s one-year anniversary. Over the past year, we showcased solutions that are proven to lower costs, increase access, and provide more patient-centered care. In celebration of this milestone, we are sharing the favorite posts as measured by Facebook ‘likes’ from our readers, who have visited the blog over 10,000 times.

 

#4 – Keeping Boston Strong: How Disaster Training at Osteopathic Medical School Helped Save Lives

In May, former RWHC editor Paul DeMiglio told the story of Dr. Danielle Deines’ emergency response to the Boston Marathon bombing. Dr. Deines’ education at the Edward Via College of Osteopathic Medicine – Virginia Campus (VCOM) required her to participate in a two-day, mandatory training curriculum on Bioterrorism and Disaster Response Program, which immersed her in real-life disaster training, field exercises and specialized courses.

(Photo courtesy of VCOM)

(Photo courtesy of VCOM)

The day of the bombing, after crossing the finish line, Dr. Deines found herself triaging runners in medical tents to make room for the victims. “The back corner became the most severe triage area, nearest the entrance where the ambulances were arriving,” she said. “I saw victims with traumatic amputations of the lower extremities, legs that had partially severed or had shrapnel embedded, and clothing and shoes literally blown off of victims’ bodies.”

Read the post: http://www.realworldhealthcare.org/2013/05/keeping-boston-strong-how-disaster-training-at-osteopathic-medical-school-helped-save-lives/

 

#3 – Making Life Easier for Patients and Loved Ones: Meet MyHealthTeams

In April, Eric Peacock, Co-founder and CEO of MyHealthTeams, contributed a guest blog about the need for social networks for communities of people living with chronic conditions. These networks allow patients to “share recommendations of local providers, openly discuss daily triumphs and issues, share tips and advice, and gain access to local services,” he wrote.

“Sharing with people who are in your shoes offers a sense of community that can’t be found elsewhere – these are people who know the language of your condition; they understand the daily frustrations and the small triumphs that can mean so much,” he added.

Read the post: http://www.realworldhealthcare.org/2013/04/making-life-easier-for-patients-and-loved-ones-meet-myhealthteams/

 

#2 – When the Health Care Blogger Becomes the Cancer Patient

In August, even as she was still undergoing daily radiation treatments, contributor Linda Barlow shared her personal story of being diagnosed with cancer and the slew of medical bills she faced even though she had insurance.

Linda Barlow

Linda Barlow

“While these out of pocket costs are certainly hard to swallow – I can think of a hundred other things I’d rather spend my money on – for my family, they are doable,” she wrote. “We won’t have to skip a mortgage payment or a utility bill. We won’t have to dip into a child’s college tuition fund. We certainly won’t have to worry about having enough money for food. But I know – from my work on this blog and with its main sponsor, the HealthWell Foundation – that many families living with cancer aren’t so lucky.”

Read the post: http://www.realworldhealthcare.org/2013/08/when-the-health-care-blogger-becomes-the-cancer-patient/

 

#1 – What If You Want Politicians to Get Moving But You Can’t Move?

Neil Cavuto

Neil Cavuto

Last week, Neil Cavuto, Senior Vice President and Anchor, Fox News and Fox Business, contributed a moving guest post about his triumphs over multiple sclerosis (MS) for MS Awareness Week. His deeply personal blog inspired resounding praise in the comments section and 1,300 Facebook ‘likes’.

“If I can pass along any advice at all, it is…to simply never accept a prognosis as is,” he wrote. “Fight it. Challenge it. ‘Will’ yourself over it. Many doctors say it’s a naïve approach to the disease, but attitude counts a lot for me with MS, as it did for me two decades ago when I was battling advanced Hodgkin’s Disease. Then, as now, it was about one day at a time, and staying optimistic and positive all the time.”

Read the post: http://www.realworldhealthcare.org/2014/03/ms-awareness-week/

 

If you would like to suggest a topic, contribute a guest post, or learn more about short-term co-sponsorship opportunities, please contact us at dsheon@WHITECOATstrategies.com. As a blog currently sponsored solely by the HealthWell Foundation, an independent non-profit providing nationwide financial assistance to insured Americans with high out-of-pocket medication expenses, co-sponsorship helps us keep Real World Health Care alive and well as a resource for journalists, health care professionals, policymakers, and patients. Plus, co-sponsorship will increase your organization’s visibility among thought leaders in the health care sphere.

Do you have a favorite Real World Health Care post? Is there something you’d like to see more of? Post to the comments section or tweet at us at @RWHCblog.

Why We Give to HealthWell Foundation – and Why You Should Too

As the head of a communications strategy shop that helps clients in science, technology, and health care, I encounter a seemingly endless number of organizations that want to do good for society and the planet.  Why then have the WHITECOAT Strategies employees – who serve as editors of Real World Health Care (RWHC) Blog – decided that the HealthWell Foundation should be one of our two charter charities, as our firm becomes a social enterprise in 2014?

David Sheon

David Sheon

Before I answer that, just what is a social enterprise?

A social enterprise is an organization that applies business strategies to maximize improvements in human and environmental well-being, rather than maximizing profits for shareholders.

Social enterprises can be structured as for-profit or non-profit organizations, but their focus is using their proceeds to do good.

We decided that organizations seeking communications firms would like to know that revenue from their work is going to help society.  And our employees like to know that too.

When we made the decision to become a social enterprise, we thought about the impact of our work globally and locally.  And that’s how we arrived at helping CA Bikes, as well as the HealthWell Foundation.

CA Bikes is a nonprofit organization founded by Chris Ategeka, a native of Uganda. The oldest of five children, Chris became an orphan and head of his household at an early age after losing both his parents to HIV/AIDS. After years of poverty and laboring in the fields, a miracle happened, as Chris says, when a woman from the United States started an organization called Y.E.S. Uganda near his village, took him in, and supported him through school. Now, Chris holds a BS and an MS in Mechanical Engineering from the University of California, Berkeley.

Many people living in rural Africa have no access to emergency medical services, and given that the nearest health clinic or hospital is often miles away, this results in needless suffering and deaths. CA Bikes builds and distributes bicycle and motorcycle ambulances to rural African villages and trains partners in their maintenance and use to provide access to life-saving care during medical emergencies. For more information about CA Bikes and to help support their work, click here.

The WHITECOAT team is honored to help Chris fulfill the mission of CA Bikes.

WHITECOAT’s history with the HealthWell Foundation dates to a discussion one of my staff members and I had over three years ago.  She told me that her best friend from college had been diagnosed with a brain tumor. He had insurance through his job, which stuck with him through the medical emergency.  His wife had been laid off of her job a month before the diagnosis.  The emotional toll of the diagnosis was awful.  I knew the couple and their children would find their own way to deal with that and there was nothing we could do. But I felt that perhaps we could do something more to find them financial support.

One call to the HealthWell Foundation was all that was needed.  After reviewing financial records and evaluating the situation, the Foundation tapped a fund reserved for medical emergencies that reimbursed not only for the co-pays associated with medication, but also for the cost of the monthly health insurance premium and related medical expenses.  This program has now transformed into the Emergency Cancer Relief Fund, which WHITECOAT is proud to help launch for HealthWell.

HealthWell has awarded more than 265,000 grants to patients in over 40 disease categories, making a profound difference to over 165,000 people faced with difficult medical circumstances in the U.S.

I hope that at this time of giving, you’ll join me and the WHITECOAT staff by donating to the HealthWell Foundation.

Categories: Cost-Savings

Give Patients the Gift of Hope and Health by Supporting HealthWell for #GivingTuesday

We are proud to announce that the HealthWell Foundation – an independent 501(c)(3) charity that provides financial assistance to insured patients living with chronic and life-altering illnesses – is joining the #GivingTuesday campaign, which launches today. 100 percent of your donation to HealthWell goes directly to grants and services that will benefit patients in need across the country. This week we are sharing some powerful real-world examples of how your gift to HealthWell will help transform lives.

Lynn Harcharik

Lynn, who received financial assistance from HealthWell for cancer treatments.

As one of our country’s most trusted independent charities, we believe that no patient, including those living with cancer, should go without health care because they can’t afford it. By donating to HealthWell for #GivingTuesday, you’ll join us in making that commitment a reality that will change lives for the better, one patient at a time – just like Lynn.

It was ovarian cancer spreading to the colon. My husband called many places, no cancer society would help! One society asked what type of cancer it was, and replied: there are no funds for ovarian cancer – we cannot help. Another organization had already used their funds. It was very discouraging, but my oncologist’s secretary told us about the HealthWell Foundation. After calling and talking to your group, the answer was YES, you would help. (Thanks!) In October of 2008, reversal surgery was done with the ileostomy. And yes, the cancer came back, or maybe was not completely gone from before, but-more chemo! Thank you for being there in my time of need. My prayers are with your group and your work. Thanks!

– Lynn (Streator, IL)

We want to make a difference for even more patients like Lynn so they can access critical medical treatments and get better. But that can only happen with your support.

That’s why, for this year’s #GivingTuesday, we’re urging Real World Health Care (RWHC) Blog readers to donate to the HealthWell Foundation’s Emergency Cancer Relief Fund (ECRF). Your generous holiday gift will help ensure that patients living with cancer are not forced to choose between paying the rent or buying food and affording life-saving care.

So what, specifically, will your tax-deductible #GivingTuesday donation do? Giving to ECRF will bring us closer to meeting our $100,000 goal by the end of the year so the fund can open in January. We are almost halfway there with more than $46,000 raised so far. Every dollar counts, and with just a little more help, we will hit our goal so that more cancer patients can start 2014 off right.

To help more families and patients afford the urgent medical treatments they desperately need, we need you to support #GivingTuesday starting today. Please contribute as generously as you possibly can.

Thank you for giving the gift of health this holiday season.

Categories: Cost-Savings

We Need a Little Certainty

When you’ve been diagnosed with cancer like me, you’re faced with an overwhelming amount of uncertainty. Did they catch it in time? Will the treatments work? And for many cancer patients, can I afford good treatment?

Linda Barlow

Linda Barlow

The Emergency Cancer Relief Fund (ECRF) could answer this question, but only if the HealthWell Foundation receives the donations it needs in order to open it.

It’s both sad and frustrating that here, in one of the most highly developed nations in the world, many cancer patients have to wonder if they can afford to save their own lives. Unfortunately, even having health insurance is not always enough of a safety net to avoid personal financial collapse while fighting the fight of your life.

As the bills start to roll in, so too does a new wave of uncertainty: Can you afford what you need to get better?

Providing assistance to people living with cancer has always been a priority for organizations like the HealthWell Foundation. Since 2004, HealthWell has been leading the way in bringing financial relief to more than 70,000 cancer patients with copay assistance through more than 20 oncology funds – yet so many more need help.

That is why I’m turning to you today. HealthWell has made the decision to create the ECRF. It is not yet open, but I want that to change. And for that to happen, HealthWell needs your help today.

Once launched, the ECRF will help people with expenses not covered under traditional current cancer copay funds, expanding services to even more cancer patients who have exhausted all other options and have no one to turn to.

For example, the ECRF can grant as little as $25 to help someone pay for anti-nausea medicine. Larger grants can also help patients overwhelmed by medical expenses accumulated during their treatment, such as medical equipment needs and diagnostic testing.

The ECRF will follow patients every step of the way through their treatment or recovery. It will almost be like having another caregiver watching out for your well-being. And for those of us who have lived through or are living with cancer, we know how important that caregiver network can be.

To that end, I would like to personally recognize and thank all of the health care providers at Abington Memorial Hospital and The Rosenfeld Cancer Center who took such good care of me during my recent treatments for breast cancer. From my initial diagnosis through my follow-up visits, every physician, nurse, therapist and technician I’ve encountered has treated me with both professionalism and the compassion and kindness a cancer patient needs to get through the day.

Compassion and kindness – they’re like life-giving oxygen to a cancer patient. But compassion and kindness aren’t just the hallmark of professional caregivers and loved ones. The ECRF will be proof of that, but HealthWell first has to raise enough money to open the fund so patients can benefit from it.

And that’s where your support comes in. If you want to show compassion and kindness to those with cancer, now is the time. Give to ECRF today so that HealthWell can launch the fund and help cancer patients avoid one more uncertainty in their lives.

With a Little Help from My Friends, Family… And Apps

“Drugs don’t work in patients who don’t take them.” – C. Everett Koop, former Surgeon General

It was an idea born of near tragedy: an elderly, diabetic father who double-dosed on his insulin therapy and suffered a medical emergency. His two sons realized that if they were more involved in reviewing their father’s daily medication and insulin regimens, it could change his behavior for the better and help him get healthier.

MedicineCabinet (5)

Photos courtesy of NextGen Healthcare

So Omri and Rotem Shor co-founded the MediSafe Project, a free mobile app that makes it easier for families and friends to give the support needed to help their loved ones get healthier and integrate healthier behavior modification into their everyday lives. In the first four months after its launch, users reported medication adherence rates of 79 percent (82.25 percent for statins) – well above the 50 percent average medication adherence rate reported by the World Health Organization.

The MediSafe Project provides an easy-to-use interface – an interactive pillbox of sorts — over iOS and Android mobile phones. Users input information about their meds by typing their names or photographing their National Drug Code numbers. The system stores the correct pharmaceutical name, manufacturer and dosage, ensuring an error-free medication list in the event of a medical emergency. Users signify taking their meds by dragging pills from the virtual pillbox into a mouth icon, which “swallows” the pills.

Users receive alerts before medication courses are completed, allowing them to order refills in a timely manner. In addition to reminding users when it’s time to take their medication, the MediSafe Project sends alerts to selected family members, friends and caretakers when a loved one misses a dose. Users can also email a personalized list of adherence stats to their doctor, giving doctors better patient oversight between office visits. A prescription page feature lets doctors “prescribe” the MediSafe project to their patients to help better monitor medication adherence.

The impact of non-adherence on the outcomes of patients with cardiovascular diseases is one example that underscores why it is so critical to implement strategies and utilize technologies that improve medication adherence.

“Medication non-adherence is a problem that costs U.S. hospitals billions of dollars every year,” says Omri “Bob” Shor, CEO, MediSafe. “An American dies every nineteen minutes from skipping or taking medication incorrectly. Our goal is to help combat this problem and encourage healthy habits among users and their support systems with easy-to-use technology.”

The MediSafe Project isn’t the only app on the medication adherence scene. The free NextGen® MedicineCabinet app lets users create and update a list of medications, including dosing and schedule information, thus creating their own “personal” medication record.

Notifications are sent for each medication and users can confirm adherence. The app was designed, in part, to improve adherence and proper use of medication by enhancing patients’ understanding of how to correctly take their medication and to recognize adverse reactions. According to the company, it also equips health care professionals with all the relevant information they need, in a way they like to view it.

“Mobile patient engagement is at the forefront of today’s changing health care environment,” said Ike Ellison, executive vice president of business development for NextGen Healthcare, in a statement. “Providing consumer technology that encourages members to control and lead healthier lifestyles is a key factor in improving outcomes.”

Michael Paquin, vice president, business development for NextGen Healthcare, added “One of our users commented on the way that she was able to, for the first time, be able to share her medication lists easily with family, friends and all her physicians. It has saved this particular patient hours of time on a monthly basis.”

Technology-based solutions like the MediSafe Project and the NextGen Medicine Cabinet are among the latest patient-directed tools that improve medication adherence.

However, providers still play an important role in assisting patients in maintaining healthy behaviors like medication adherence. The American College of Preventive Medicine offers a SIMPLE approach on how providers can help their patients take their medications as prescribed.

Barriers to medication compliance abound, with memory issues, lack of support, and lack of education just being a few. What is behind these barriers? How can patient behaviors and motivations be changed?

MedicineCabinet2 (2)

Categories: Access to Care

Keeping Boston Strong: How Disaster Training at Osteopathic Medical School Helped Save Lives

VCOM Image 2

The Bioterrorism and Disaster Response Program equips students at VCOM with critical skills through field exercises and more (photo courtesy of VCOM).

When Danielle Deines crossed the finish line of the Boston Marathon on April 15, she had no idea her unique medical training as Doctor of Osteopathic Medicine would make a real difference in the life-and-death events that would soon unfold.

A 2012 graduate of the Edward Via College of Osteopathic Medicine – Virginia Campus (VCOM), Dr. Deines immediately sprang into action after the explosions violently rocked the most prestigious race in the country. Triaging people in the medical tent to ensure they received the care they needed, she helped make room for victims on a moment’s notice:

“They asked all of the runners to move to the back of the tent,” Dr. Deines said. “Once there as the volunteer physicians headed to the explosion sites, I made an effort to get to my feet and informed the nurse near me that I wanted to help. I was asked to discharge runners who were able and interested in leaving to help make room for the victims who were starting to be brought in from the street. I cleared those wishing to leave and signed off on their discharge paperwork, then helped to get them out of an entrance that had been made in the side of the tent.  We then moved the freed up cots to form triage areas. The back corner became the most severe triage area, nearest the entrance where the ambulances were arriving. I saw victims with traumatic amputations of the lower extremities, legs that had partially severed or had shrapnel embedded, and clothing and shoes literally blown off of victims’ bodies.”

Dr. Deines’ ability to help at the time of urgent need did not come coincidentally. Her education at VCOM equipped her — and all other graduates of the Blacksburg, Virginia school — with the critical life-saving skills that are needed when attacks or other emergencies strike.

The Bioterrorism and Disaster Response Program, a two-day, mandatory training curriculum for all second-year osteopathic students at VCOM, has immersed students in real-life disaster training, field exercises and specialized courses since its inception in 2003. This comprehensive approach gives participants expertise in areas including terrorist and major disaster response, hospital planning, behavioral risk factors, psychological response to trauma, and media relations.

Students who have completed the program now serve as lifelines, having the ability to respond to catastrophes locally, nationally and internationally – from Hurricane Katrina to the Virginia Tech shootings, tsunamis and tornado damage in Virginia.

Now more than ever, a working knowledge of disaster response issues is central to providing quality patient care.

“All medical students and practicing physicians need to be able to respond to natural and manmade disasters.  With changing global weather patterns such as global warming and changing political climates, disasters are now a part of the framework,” said Dr. James Palmieri, Associate Professor and Dept. Chair at VCOM. “I always teach the students that no matter what kind of disaster takes place, both natural and manmade, it will always begin in someone’s neighborhood and the local medical community will be part of the initial response.  In light of today’s instant communication, if and when you respond, the world will see you as the local expert.  You had better know how to respond properly for both your benefit and that of your patients.”

How can VCOM’s leadership role in disaster response training be replicated by other medical training programs?  In what ways can more medical schools develop and leverage their curricula to prepare students for disaster response?

Today, more than one in five medical students in the United States are training to be osteopathic physicians, who can pursue any specialty, prescribe drugs, perform surgeries and practice medicine anywhere in the U.S. Osteopathic physicians bring the additional benefits of osteopathic manipulative techniques to diagnose and treat patients, helping patients achieve a high level of wellness by focusing on health education, injury prevention, and disease prevention.

For students who are interested in going into osteopathic medicine, visit the American Association of Colleges of Osteopathic Medicine, www.AACOM.org; and VCOM at http://www.vcom.vt.edu/.

It Takes a Community for Effective Disease Prevention and Management

To help stem the tide and high cost of persisting disparities in U.S. health care, providers are leveraging Community Health Workers (CHWs) as critical players in improving health outcomes by successfully linking “vulnerable” patient populations to better care. Living in the communities where they work, CHWs understand what is meaningful to those communities, communicate in the language of those they serve, and incorporate cultural buffers to help patients cope with stress and promote health outcomes.

As the CDC reports, growing evidence supports the involvement of CHWs as a critical link between providers and patients in the prevention and control of chronic disease:

  • They help high-risk populations, especially African-American men in urban areas, to control their hypertension.
  • They enable diabetic patients to reduce their A1C values, cholesterol triglycerides and diastolic blood pressure.
  • Their interventions improve knowledge about cancer screenings as well as screening outcomes.
  • Their interventions help patients reduce the severity of asthma.

Many Americans – especially those with low incomes, have no insurance or face other socio-economic barriers to primary care – often distrust the health care system, or lack the resources and awareness needed to take charge of their health. As a result, they wait until health issues and chronic disease escalate enough to drive them into the emergency department, where they receive short-term solutions that drive up the total cost of health care.

CHWs are changing that, community by community. Examples of CHW programs – both at home and abroad – abound. One is Penn Medicine’s IMPaCT Program.

IMPaCT (Individualized Management for Patient-Centered Targets) pairs patients in need of extra support with relatable neighbors and peers (people who have shared language, ethnic and geographic backgrounds) to assist them in navigating the medical system and identify the underlying causes of illness.

“Lower income patients tend to poorly manage chronic disease and have worse health outcomes than other patient populations,” explains Dr. Shreya Kangovi, Director of the Penn Center for Community Health Workers, which houses the IMPaCT program. “They are less likely to get preventive care and more likely to end up in the hospital. This scenario leaves health care practitioners frustrated, because they can’t move the needle on health outcomes. And it makes it difficult for the health system to meet its quality targets.”

Dr. Kangovi notes that many patients served by IMPaCT didn’t have a relationship with a primary care physician prior to joining the program.

“There is a lot of focus today on reducing hospital re-admissions,” she says. “But before we can reduce re-admissions, we need to make sure patients have a substitute for the emergency department.”

She shared the story of “Ben,” a young man with a bad case of lupus and no insurance. Ben had been visiting Penn’s Emergency Department regularly for lupus flare-ups. There, he received steroids and pain medications before being sent along his way. Thanks to IMPaCT, Ben was set up with a primary care doctor who understands his health problems, and placed Ben on a better medication regimen. Not only does Ben now feel better, he has more trust in the health care system that he sees as an ally, she says.

IMPaCT currently serves about 500 patients via two programs – one for hospitalized inpatients and one for primary care outpatients. The program’s CHWs meet with patients upon admission to the hospital to set short-term goals and identify pathways to solving their clinical and socioeconomic hurdles. They advocate for patients during their hospitalization, then work with them during discharge and beyond to get them connected to resources in their community. On the primary care side, patients work with their IMPaCT partner over six months to break long-term health goals down into smaller, achievable steps.

“Once patients leave the hospital, real-life issues intervene,” Dr. Kangovi says. “IMPaCT’s community health workers address these health and life issues on the ground, and do so much better and at a much lower cost than clinically trained personnel.”

Are CHWs making a difference where you live? How are they helping to reduce costs and improve access to health care?

Categories: Access to Care

Hospitals, Physicians Embrace Strategies To Reduce Cost of “Frequent Flyer” ER Visits

Pardee Memorial Hospital in Hendersonville, N.C., shaved nearly $405,000 from its Emergency Room (ER) expenses over a one-year period thanks to an integrated program that its founder calls a “patient-centered medical home on steroids.”

The program, Bridges to Health, helped its uninsured participants reduce their ER visits from an average of seven per year (at a typical cost of $14,004 per person) to three per year (at an average cost of $2,760 per person). Another indicator of success: 10 participants secured employment and six previously homeless members found places to live by the end of the first year.

It’s estimated that non-urgent Emergency Department (ED) visits cost the U.S. about $4.4 billion annually. At Pardee Memorial Hospital alone, 255 frequent users (“frequent flyers”) of the ED racked up more than $3 million in unpaid medical bills. Frequent flyers account for up to 40 percent of total ER visits nationwide.

Bridges to Health decreases ER expenses by providing this patient population with primary care, behavioral health services and a nurse case manager through bi-weekly health clinic visits.

“Many of these people just went to the ER because they were in pain or scared,” said Dr. Steve Crane, a family physician who started the program. “You see them going back so many times because their real issues are not supposed to be treated in the ER and are not taken care of.”

The Pardee Bridges to Health free clinic integrates medical checkups and group therapy, with doctors providing treatment and patients offering one another tips ranging from how to obtain legal assistance to saving money on food and shelter. In this way the program addresses the two main problems seen in these patients: lack of social support and access to regular primary care.

Although the results of the program are promising, Dr. Crane cautions that the patient group is small and that it only works for participants who attend the clinic meetings.

Another example of how hospitals can lower frequent flyer ER visits is in the story of Providence St. Peter Hospital (Olympia, Washington). The first step was to join a special community program called the Emergency Department Consistent Care Program and CHOICE, a unified program involving five area hospitals and a non-profit regional coalition of health care providers.

This collaborative effort resulted in ER visits among frequent flyers shrinking by about 50 percent, for a cost savings of nearly $10,000 per patient. That translated to a $2.2 million reduction in ED and inpatient expenses over two years at Providence St. Peter’s alone.

This program flags patients who visit the ED at least twice in one month or four times in six months then examines their cases for narcotic dependency, mental health issues and other factors. The program team uses that data to identify patients, then develops individual care plans and offers the assistance of primary care physicians, clinicians and specialists skilled in the patients’ particular needs.

What’s key to the success of the program? It effectively coordinates efforts with other hospitals in the area, according to its administrative coordinator, ensuring that frequent flyers get a consistent message wherever they go.

What approaches should be pursued to provide more efficient care systems while decreasing readmissions for frequent flyers? Encourage more doctors to keep their offices open longer? Leverage mental health coalitions that focus on continuity of care instead of short-term fixes?

Tell us what you think.

Categories: Cost-Savings