Providence works with outside providers through platform to stem ED repeats

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Providence Healthcare System is collaborating with providers outside its organizational walls and enlisting technology to successfully curb unnecessary utilization of its emergency departments.

Physicians and staff in the system’s emergency departments were seeing unusually high rates of patients who were frequently coming to the EDs for care—for example, some patients were visiting EDs at least six times in six months, and some were registering as many as 20 visits in a year.

Providence is an expansive delivery system with 50 hospitals and 829 clinics across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.

Knowing that many of the patients had needs that extended beyond the ED, the organization knew it needed to go beyond its delivery system. Consequently, Providence began collaborating with outside providers that included primary care, behavioral health and specialty providers. To facilitate this, it also adopted a care collaboration platform from Collective Medical. The platform gave staff and clinicians insights into patient needs that include existing conditions, safety concerns, comorbid behaviors and substance use disorders.

But what was really needed was a focus on social determinants of health and creation of the Better Outcomes through Bridges (BOB) program.

“We started looking at our more vulnerable populations and asked how we could help these patients coming in over and over who we could not do much for while they were here,” says Becky Wilkinson, supervisor of BOB. “We needed help to address their needs in the community once they left.”

With the BOB program, supported by the Collective Medical platform, ED physicians met with case managers, behavioral health specialists, primary care providers, churches and community leaders to assess the needs of these people and how to lower unnecessary ED utilization.

Physicians also enlisted specialists to work on securing housing, mental health support and employment opportunities. For example, tiny homes for transitional housing were built for some individuals, and part of the parking lot was turned into an area for car camping with access to running water and bathrooms. One elderly woman who had been living on the street with her daughter used the ED about 65 times a year before getting help through the BOB program; as a result of the program, neither of the women have turned to the ED for treatment.

As patients begin to feel understood, they become more willing to comply with case managers and follow their care instructions, Wilkinson notes. In total, Providence reduced ED utilization by 41 percent by coordinating care for SDOH patients. “Everyone wants to feel heard, and by taking the time to collaborate and understand their full story, the patient feels important and more open to letting us guide their care. This collaboration is more than just care—it’s about building relationships, investing in patients as people and guiding them back to better health.”

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