Reducing emergency room use by targeting 'super utilizers'

Project ECHO - driven by a single doctor with a cause - pulled together a team of specialists to develop a model that combines technology with collaborative care and careful patient tracking to help cure for diseases spread to patients around the world through community healthcare agents, as opposed to only specialty centers. This kind of "disruptive innovation" is effectively working to demonopolize health care knowledge and access, and lends to a health system capable of meeting today’s soaring demands for care.

The highest hospital costs come from preventable emergency room visits. A doctor in Camden developed a home visit program which gives better and cheaper care.

Nurse practitioner-led clinics in Ontario, Canada, are open for same-day appointments to care for people without a primary health-care provider and decrease the number of emergency-room patients.

Hidalgo Medical Services is a nonprofit public health clinic that has set out to develop a model for delivering quality, affordable health care to rural communities through a comprehensive approach that addresses multiple patient needs at once.

Patients who are suffering from some mild mental health issues often forsake going to a psychologist or psychiatrist because of the long wait time for a specialist. Different counties in Wisconsin are piloting a program in which primary care doctors can call psychiatrists for suggestions on treating patients with mental health issues. Doctors think that the program is an accessible model that offers quick assistance to people who need it.

Over 50 percent of Wisconsin counties lack mental health professionals to serve the populations, and the shortage directly affects children’s mental health. The Institute for Healthcare Improvement has submitted funds to a clinic in Ashwaubenon to integrate mental health counselors into primary care work. The effort is nationwide and has shown to be effective in identifying early signs of anxiety and depression beyond patients’ awareness so that counseling is accessible and treatment can be administered.

In collaboration with Intuitive Health, UF Health has opened three centers that offer both ER and urgent care 24/7, at the same facility so patients don’t have to decide themselves which care they need. Instead, doctors at the center make that decision and then the system bills the patient accordingly. This helps them avoid taking on expensive ER bills when that level of care may not have been necessary.

Carter Kits are provided to trained first responders, and contain sensory items, like noise-canceling headphones and weighted blankets, that help distract children with Autism Spectrum Disorder from the stress of being involved in an emergency situation. There are currently 6,000 Carter Kits in circulation across 34 states and one Canadian province.

Since 2017, the Defeat TB (tuberculosis) program supported by USAID introduced a patient contact tracing program in Uganda wherein health workers and facilitators have been trained to trace a patient with multidrug-resistant TB back to their community to screen family members, conduct tests, and refer them for Xrays or treatment if needed. Introduced in the Mulago referral hospital, the program has since expanded to 16 other centers. Along with counseling, follow-ups, and provision of food assistance, it has helped increase the TB detection and treatment rate over the years.

A pop-up mobile clinic in Nevada's Lyon County is providing free dental care to underserved communities as a way to address the lack of practicing dental providers in the region. The response thus far has been overwhelming, but the medical students who work out of the clinic are still planning to expand their outreach efforts to reach more communities.