We've written before about the Super Utilizer or Super User problem at our hospitals' Emergency Rooms. And we've written about how the most successful approaches to solving these issues are integrated and holistic.
But we were still shocked to see a statistic about Emergency Room usage across the hospitals in the country -- and this reality has serious implications for providers and hospital systems.
Fierce Healthcare reports that Researchers from the University of Maryland School of Medicine analyzed data from 1996 until 2010 and determined that 47.7% of the medical care delivered in the US is in the Emergency Room.
Further, over that 14-year period, ER usage increased by 44%. It seems that because vulnerable populations use the ER more, the increase in usage can be attributed to those populations: African-Americans, Medicare and Medicaid beneficiaries, etc.
It's an interesting data point because it's dramatic, yes, but also because the increase in ER usage during that 14-year period is the exact opposite of the intended trends in the medical field. As a healthcare system, we're working towards value-based care. We're working towards decreasing readmissions, length of stay, and costs, and improving outcomes. We're not trying to encourage expensive, ineffective, un-integrated approaches.
Usually, human beings act in deeply rational ways that we would understood if we really knew all of the facts about their situation. This extreme usage of the country's ERs has to be understood as an indication on needs on the part of their patients. (Whether for immediate care, 24-hour care, care that comes with fewer questions about insurance coverage, or something else.) That said, this kind of ER-based care isn't good for patients and isn't good for hospital systems. It's costly, allows patients with complex situations to fall between the cracks, and often doesn't identify the root cause of the visit.
Realistically, we're not going to reverse the tide of ER visits. But what we can do is work in thoughtful, collaborative ways as providers so that when someone does come into the ER, we're still providing integrated, team-based care. iClickCare is one tool to facilitate that, but, simple conversations with patients and colleagues is another tool.