The Emergency Department is Overflowing With Opportunity

In a recent study it was concluded that the U.S. healthcare system should employ simple solutions that will improve patient care and save costs due to poorly managed care transitions, which are currently contributing to high spending. As we begin to assess the past year and look forward to strategic planning for 2013, follow-up communications and more efficiently managed care coordination are areas of significance; both in the hospital and in the emergency department. With 50 percent of hospital inpatient admissions coming through the ED, and 40 percent of patients who are treated and released by ED not having a primary care physician, we look to the opportunity the ED presents for continual patient communication.

Patients don't see the emergency department as a portion of their experience separate from the total care continuum, especially if they're admitted. With a growing number of uninsured patients, the emergency department becomes the easiest access point for care, especially if patients are without a primary care physician, and the entry point for new patient populations into the system. Hospitals and health systems are beginning to panic instead of looking at the opportunity this presents for a new patient population and in-revenue opportunities. Providing solutions to ensure top-scoring patient satisfaction, reducing readmissions and identifying ways to capture revenue is key in a time when reimbursement penalties seem inevitable and the main focus today.

In preparation for 2013, it's more than top-box patient satisfaction and more about addressing many issues in a more seamless fashion focused on the patient. By addressing patient satisfaction and reducing readmissions, hospitals will actualize maximum reimbursement, but that's not enough. Many systems are focused on growth and downstream revenue opportunities. One easy-to-target revenue opportunity is providing post-discharge follow-up to treated and released patients seen in emergency departments. By collectively and seamlessly addressing patient satisfaction, discharge and medication compliance, appointment follow-up and scheduling appointments, hospitals will see better patient compliance, fewer inappropriate visits to the emergency department, reduced readmissions, improved patient experiences as well as better patient retention and financial return.  

Downstream revenue opportunities in the ED

While the emergency department is flooding with patients, there is significant opportunity for downstream revenue by looking at two key factors: reducing risk for readmissions/reimbursement penalties and preventing patient loss from the system after they are released from the emergency department.  

Readmissions often occur because of lack of communication and clarity around discharge instructions. Of 1,159 hospitals in a Consumer Reports study, nearly 500 hospitals earned the lowest score for communications regarding new medications and plans following discharge, and none earned the best communication score. "That's a problem because drug errors in hospitals are common and sometimes serious, and poor discharge planning can lead to readmissions," according to the report. Readmissions can cause additional stress and suffering for the patient, and with recent changes to Medicare reimbursements, can place a heavy burden upon hospitals that are receiving significant financial penalties as a result of these readmissions. Therefore, follow-up post-discharge becomes a win-win for both the patient experience and hospital funding.

As uninsured patient numbers rise and ED volume goes up, it's a common pain point that patients use the ED as an avenue for minor episodic care, but for many of these patients, it's the first touch-point in the care continuum. It is key to look at the opportunity this presents. With more than 40 percent of patients who visit the ED not having a primary care physician, post-discharge communication to this patient population can provide the opportunity to not only check in on these patients from a health and patient satisfaction standpoint, but to also refer and schedule the patient to an in-network physician. This helps improve the patient experience, reduces the likelihood for readmission or inappropriate use of the emergency department, thus driving downstream revenue as well as patient retention and growth.

Overall, post-discharge communication works to improve population health management among high-risk patients, boosts patient compliance, improves the patient experience, provides opportunity for more efficient care coordination and prevents unnecessary readmissions — all potential drivers of hard and soft revenue leads. Specifically, by looking into strategic post-discharge planning and outbound communications, healthcare organizations can heavily impact their bottom line by shielding their reimbursement exposure and routing ED patients to the proper point of care, in-network.

When planning a strategic post-discharge and outbound communications plan, it is important to remember that not all hospitals and systems are the same. The same goes for the patient. In structuring these plans, looking at industry best practice and benchmarks as reference is always a great starting point, but be sure to consider what uniquely works for your hospital and your patients when creating your follow-up plan. In regards to the patient, targeting and understanding your patient population and the different demographic segments enables more effective communication and a better patient experience.

Steve Whitehurst is chief customer and strategy officer at BerylHealth, a technology based patient experience company. Mr. Whitehurst's focus at BerylHealth is to manage the overall patient experience and client facing teams, while also monitoring and aligning BerylHealth's overall business strategy with that of healthcare organizations' concerns within the market. Mr. Whitehurst welcomes your communication at, or he can be found on Twitter @Steve_Beryl.

More Articles From Beryl Health:

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