Data tracking, sharing key to cutting improper ED use

Program cuts narcotics trafficking, promotes care coordination
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Electronic data sharing has been key to collaborative effort to reduce emergency room visits and better coordinate patient care in Washington state.

A new report published by the Washington State Health Care Authority focused on a collaboration between between the Washington Chapter of the American College of Emergency Physicians (WA-ACEP), the Washington State Medical Association, the Washington State Hospital Association and HCA in which seven best practices were implemented, including tracking frequent users of emergency departments and adopting electronic tracking systems to exchange patient information. 

Based on data from the first six months of the program, the state has saved more than 10 percent in Medicaid fee-for-service emergency care costs. That savings is projected to grow to $31 million for the fiscal year.

"This shows that medical providers can work together to improve patient care and save money," Andy Sama, president of the American College of Emergency Physicians, said, according to an announcement. Sama called the program "a model for the nation."

Achievements in the "ER is for Emergencies" program, according to the report, include:

  • A 250-percent increase in the number of providers registered in the state's Prescription Monitoring Program, which is designed to identify patients shopping for narcotics. The program's best practices called for 90 percent enrollment of emergency department prescribers by December 2012.
  • An increase in the number of hospitals exchanging ED information electronically from 17 to 85, with 10 more in the process of implementing the exchange system.

The HCA also made available monthly feedback reports with prescriber-specific data including the number of pills prescribed.

"Patients have fewer emergencies when a primary care physician is implementing a cohesive care plan for them," Stephen Anderson, immediate past president of the Washington state chapter of the American College of Emergency Physicians, said. "Prescription drug abuse is decreased. Hospitals can compare performances with their peers, identify and share best practices, and help patients receive care in the most appropriate and cost-effective setting."

Though the authority plans to submit another report at the end of 12 months, its recommendations include ongoing promotion of electronic client care plans among providers.

At least 41 states have enacted legislation to create prescription-tracking databases, and New York's I-STOP (Internet System for Tracking Over-Prescribing) legislation has gained a lot of attention as a means to curb prescription trafficking. California's budget woes, however, have had officials there complaining that they lack the resources to use its database effectively.

Meanwhile, a new FierceHealthcare special report on improving ED flow points to the Washington state effort as an example of using metrics to improve care and save money.

To learn more:
- find the announcement
- here's the report (.pdf)

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