Been to the Emergency Room a Lot? Let’s Talk

Jan 25, 2013

If you’ve been to an emergency room in Washington in recent months, you're probably in a new database.

The goal is to treat more injuries and illnesses outside the emergency department, in a simpler setting, which should save money, curb drug abuse and also benefit patients.

Washington's hospitals and doctors have agreed to enter some basic information about their emergency patients into a computer system. Once you hit your fifth emergency visit per year, the hospital will assign a case manager to look at your records.

Some patients have a legitimate reason for multiple visits, while others have a problem with insurance or an untreated medical issue.

"A regular person doesn't want to go to the emergency room all the time, so if they're going that many times it's usually because they need some help," says Amber Theel, director of patient safety for the Washington State Hospital Association. "This gives us the ability to actually identify these patients that need extra help."

If you already have a primary care provider, the case manager will notify that doctor or nurse. Otherwise, they'll help you find a regular physician.

Find the "frequent flyers"

The program originated with Medicaid, the government health program for low income people. State government has been trimming costs, and some patients – especially with mental or substance abuse problems – were spending a lot of time in the ER.

At one point, the state threatened to stop paying hospitals and doctors for treating the so-called “frequent flyers.” That spawned a lawsuit. The current program was a compromise, agreed to by the state, doctors, and hospitals.

A report to the legislature shows having the database and the case management, along with five other best practices, should save Medicaid about $31 million a year.