Improved patient outcomes and reduced healthcare costs demonstrated through appropriate and timely care of high utilizing patients.

In a study published in Annals of Emergency Medicine, Waller found if high-utilizing healthcare users were provided with appropriate and timely care, patient outcomes were improved, hospital visits were drastically reduced, and healthcare costs dropped significantly (2011).

The study focused on high frequency utilizers of the emergency department (ED). The project’s goals were to identify who these high-utilizing patients were, evaluate them and treat them to help reduce costs and hospital visits. High-utilizing patients were identified through the hospitals electronic medical record (EMR) data as patients who visited the ER over 10 times in a single year – in 2007. In 2008, a clinic was opened to help these patients (Waller, 2011). In the clinic, the patients were evaluated, and were put through personalized medical interventions. After six months time, these patients were then transferred to a primary care doctor. The patients were scheduled an initial one-hour evaluation from the primary care physician, with an additional 5 or 6 follow up visits that were 30 minutes long. All patients were seen by a medical social worker 1-3 times during their treatment (Waller, 2011).

The results of the pilot project were very promising. There were 30 patients of varying medical conditions such as prostate cancer and poorly treated chronic conditions that were provided the intervention. On average, patients visited the clinic 6 times over the period of the study (Waller, 2011). Before the study began, this group of patients had a combined total of 904 emergency department visits from the previous 12 months. After one year of the clinic being open, ED visits dropped to 104 visits over a one year period for the same group of patients (Waller, 2011). Once the clinic had closed completely, the patients ED visits had dropped to 89 visits a year. This was an 85% decrease in ED visits all due to timely and appropriate care. Moreover, in 2007 the healthcare costs for these 30 patients totalled $1.2 million. In 2008, after being treated at the clinic, their healthcare costs dropped to $0.1 million for that year – a decrease of $1 million over a one year period (Waller, 2011).

The study shows that high intensity evaluations and personalized treatment plans for high-utilizing and high-cost healthcare users can significantly reduce healthcare costs and hospital visits, due to improved patient outcomes. This also helps with healthcare system sustainability and helps to create well organized and better coordinated primary care (Waller, 2011). Overall, this is why software, like Catalytics Inc., that helps to identify high-utilizing and high-cost patients early on is important for our healthcare system today.

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Waller, R. C. (2011). 151 Biopsychosocial Intervention of High Frequency Emergency Department Utilizers. Annals of Emergency Medicine, 58(4), S228.