Becker's Hospital Review

14 CLIC UChicago cut non-urgent ED visits by 45%: Here's how By Mariah Taylor operations. UChicago Medicine cut its nonurgent emergency department visit rates by 45% with a single initiative. The UCM Medical Home and Specialty Care Connection program launched about 20 years ago with the goal of providing patients who visited for nonurgent reasons with a medical home outside the ED. About 17% of patients who visited a UChicago ED received assistance from patient advocates in the program. They helped patients find a primary care physician, resolve pharmacy issues, address social determinants of health, and visited patient's bedside or called to offer help. Many of the patients receiving help come from disadvantaged neighborhoods. "It's generations of residents who, for good reason, have not been able to trust the medical system," Melanie Francia, MHSCC patient advocate manager, told the American Hospital Association. "That's why education is such a huge part of our program, because we want people to understand that there are places in the community that are meant for this, meant for them and will take care of their needs." In the last nine years, the program has prevented approximately 9,487 trips to the ED and saved an estimated $2.9 million. Across the nation, about one-third of the ED visits qualify as nonurgent, and cost an estimated $32 billion annually in healthcare spending, according to a Portland-based University of Southern Maine policy brief. n Breaking the discharge bottleneck: 3 systems' strategies By Paige Twenter P lanning a patient's discharge the day they are admitted is important — but not enough to fix the complex bottlenecks that slow hospital throughput and lead to emergency department boarding. ese three systems are taking distinct approaches to smoothing the discharge process and reducing readmissions. Universal Health Services (King of Prussia, Pa.) Universal Health Services employs an AI voice agent to call patients aer they are discharged, reducing readmission risks and saving hundreds of thousands of dollars. e system piloted the tool at two facilities, expanded it to 14, and then rolled it out to the medical division across all 29 acute care hospitals. Before adopting Hippocratic AI's technology, a variety of staff — mainly nurses and in some facilities, residents — called patients post- discharge. Mike Nelson, senior vice president of strategic services at UHS, said the traditional process came with challenges: staff had high hourly rates, few patients would answer and the system does not use automated dialers — all resulting in unproductive phone time. Some patients who do answer the call seek a deeper connection and want to discuss non-medical topics. While the interaction may be more meaningful, it consumes time that staff could spend on other patients, Mr. Nelson said. "We had one patient that spent more than an hour on the phone with a Hippocratic AI agent, and the patient felt great about the phone call "We have to educate our providers about what value-based care means," he said. "It doesn't just mean value-based contracts, which are primarily based around diabetes and all things primary care." Better data infrastructure is also critical to the effort. Many systems currently lack comprehensive data on individual physician performance across quality, productivity, patient satisfaction and cost, making it difficult to have transparent conversations about performance and resource allocation. Industry-wide alignment would ease the transition as well, Dr. Katakam said, because many health systems still compete for physicians based on RVU rates. "What would help is if all health systems did the same thing, where they all held people accountable to the same things," If we all have the same thing — meaning RVUs plus quality — then it becomes a little bit easier. But when systems are just playing the RVU game, it's not easy." When physicians understand that value-based care reflects what matters most to their patients and their specialty — including access, surgical outcomes, complications or follow-up care — they become more willing to embrace accountability. "Once they understand that, they will be willing to hold themselves accountable to what is important for patients in their specialty," Dr. Katakam said. "[Value-based care] doesn't have to have any connection to contracts, but it does need to have connection to what value means to their patients and their specialty." n

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