Spotlight: A Data Driven Approach to Reducing High ER Utilization by Deploying Non-Clinical Resources During Covid-19
As health systems actively mobilize to prepare for the growing number of COVID-19 cases, many changes in day-to-day practices are occurring in order to ready the hospitals for this global pandemic. Some of the courses of action taken over the last few weeks include the cancellation of elective procedures, a swift scaling in the use of virtual care when appropriate, and pivots in specialties to bring more resources to departments where it is needed, just to name a few.
Since about 5% 1 of COVID-19 patients require hospitalization, emergency rooms everywhere are triaging with greater scrutiny than ever before. This is to allow for space for the sickest of patients and mitigate unnecessary ER utilization. As we know, a big initiative here in the U.S. is to ensure proper ER utilization, even prior to the onset of this pandemic. It is estimated that 30% of emergency room visits 2 could be avoided. We know that within the Medicaid population specifically, this number is actually much higher.
Social Determinants of Health (SDOH) interventions play a big part in strategies to reduce ER utilization and, ultimately, improve health outcomes. As quoted by Alexandra Drane of Rebel Health & ARCHANGELS this past week during the Mass Challenge COVID-19 Innovation Summit, “when life goes wrong, health goes wrong”. During this crisis, SDOH are playing a bigger part in the overall health of people than ever before.
Some interventions to proactively reduce ER admissions by addressing SDOH involve ensuring that upon discharge, the patient has a ride to their subsequent follow up appointment. It also means ensuring a successful continuum of care through proactive engagement and placing members with the right providers or care facilities for follow up. It also means addressing food and housing insecurity, among various other non-clinical interventions.
How can organizations proactively reach out to members and patients to ensure that these various needs are consistently being met? Algorex Health has robust data sets and algorithms that can help your organization identify and scale various SDOH programs. As seen below, these are just a few of the risk factors models can predict when looking at populations.
Furthermore, our teams are equipped to help health plans, health systems, ACOs, state agencies and more deploy deliverable programs at scale to measure to outcome and address these needs. Resources such as community-based organizations (CBOs) are more important than ever as we think about the shifting landscape of healthcare and the downstream impacts of this global pandemic on populations.
We are here to help you plan a clear path forward with these programs using real data, and are committed to operationalizing these resources with our team of experts.