How Tele-Navigation Reduces Admissions, Cuts ED Costs
There were barriers, especially when it came to physicians, Pete Shelkin, Presbyterian's vice president and CTO, said. Many were concerned that patients would fall through the cracks and didn't trust that patients would get an appointment with a PCP in a timely manner. There is a perception of EDs as a safety net, he added, and providers do not want to turn anyone away.
"It's one thing to get everybody to agree [to] change culture, it's another to get everybody to agree how to do it," he said.
The organization responded with a guarantee that patients would get an appointment in 12 to 24 hours or would be diverted to urgent care if that was not possible. It also spent lots of time and effort on risk analysis and scenario planning. Physicians contributed to establishing the criteria for which patients would be served by the navigation program.
Now "providers love this program," Johnson says. That's because they want to help their patients navigate the system, understand their insurance benefits and get access to and feel comfortable with visiting primary care physicians.
In the first 47 weeks of the program, 10% of overall ED visits were navigated; an average of 23 patients per day across the two EDs that were live at the time.
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