Connecticut hospital cut ED visits by nearly 50%

Norwalk (Conn.) Community Health Center underwent big changes in the last year to meet the needs of the community amid rising inflation, diminishing reimbursement growth and a crowded emergency room.


The safety-net hospital turned to digital technology to optimize capabilities and provide seamless access for patients, especially the population of undocumented immigrants Norwalk Community serves. One of the biggest transformations has been around reducing ED visits and increasing ambulatory services for the community.

"Technology has been pivotal to that and making sure we can get patients access to care in a lower cost setting than the hospital," said Kenneth Waller, CEO of Norwalk Community Health Center. "Mobile health technology gives us the opportunity when a patient presents at the ED, we can create a virtual triage for them through our on-call provider and then a decision is made whether the patient can get an appointment the next day or should be seen in the ER. That's the core business model and service delivery model."

Top leadership worked to create buy-in from providers and administrators to implement the technology and new processes so everyone understood the "why" behind the change.

"We created a culture that was needed to gain buy-in, and as we started to roll out the project, people saw using technology could help keep our waiting room open and people in the ER needing access to care. We also triaged patients virtually to schedule appointments within 48 hours," said Mr. Waller. "That all was a factor in getting hospital leaders and providers to come along and implement this program."

Norwalk Community reported a near 50% reduction in patients getting care at the ED in the last month with the virtual triaging process and the ER has been more clear for high acuity cases.

He said having the real-time data allowed his team to identify duplication of services and costs, and then improve service deliverables and outcomes as a result. Norwalk Community was also able to reduce inefficiencies with its data-driven approach and support the community to keep them out of the hospital.

In the next year, Mr. Waller aims to revisit interoperability and data sharing capabilities laid out in the 21st Century CURES Act to optimize resources available.

"We want to see how far we can push that with local community-based organizations," he said. "A lot of the participants are without medical homes and in need of services, and we want to be the consortium of providers, medical and nonmedical, that can wrap services around these residents. Social determinants of health are key to getting good outcomes."

The federally qualified health center will zero in on housing and food efforts to make sure community members have access to homes and good quality food. They also are working on a grant for additional service to support Black maternal health.

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