Mercy PHO Emergency Department and Inpatient Discharge Process
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Transcript of Mercy PHO Emergency Department and Inpatient Discharge Process
Tiffany Francis, MPHLori Vollstaedt, BSN, RN
Mercy Physician Community PHO• 145 Primary Care and Specialty Care
Physicians• 38 PCPs, 20 utilizing Crimson Care Registry• 6 MIPCT Practices• 3 Hospitals in St. Clair County, MI– St. Joseph Mercy-Port Huron, our affiliate– Port Huron Hospital, independent– St. John-River District
Discharge Process• St. Joseph Mercy Port Huron
– Daily feed through secure Trinity email system of all inpatient and emergency room discharges
• Port Huron Hospital– Daily feed through a secure web portal of all
inpatient and emergency room discharges
• St. John River District/Outlying Facilities– No current PHO process, though physicians
occasionally get their information through portals that they have access to individually.
Challenges We OvercameWorking with a “competing” hospital to
get data to promote better health in our community
Administrative burden of handling data in a timely manner
Training of offices on what to do with the data
Decreasing ED utilization for PCS diagnosis…a work in constant progress!
Internal PHO Process• Team Member accesses both
hospital’s discharge files and saves to our local drives in excel• Team Member separates each
physician onto its own formatted excel page by group• Physician group excel pages are faxed
or emailed securing to each office with DC for that day
Registry Component• Discharges for physicians on our
registry are added a service entry with a note by our Team• Physician office will then see the
service (ER or IP stay) and admitting diagnosis as well as dates of service
Care Manager Process• If office is a MIPCT office:–Complex Care Manager accesses the
excel file through the shared Trinity drives
–CCM makes the calls to patients who are DC from the hospital or ED
–Calls are logged on the log the Care Management Team uses
–Calls are logged in Crimson when there is a goal set or follow up needed.
Office Process• We train our offices to utilize these lists
and contact the patients to get them into the office after an ED visit or IP admission• Offices value the information and the
ability to get patients in quickly for follow up care• Since many health plans incentivize offices
for seeing patients post IP stay, our offices really appreciate the daily lists
Findings/Quality
• We routinely track and share information with our Quality Committee and physicians related to time of day and insurance type.• Find that most ED visits are M-F
9AM-5PM• Most are Medicare • Diagnosis are Primary Care Sensitive
Top 10 Diagnosis for ED
Time and Insurance September 2013
• 1435 ED Visits between SJMPH and PHH• 654 between hours of 9AM-5PM• 373 between hours of 5PM-9PM• 408 between hours of 9PM-9AM• 115 Uninsured• 246 Medicaid• 644 Medicare• 430 Commercial Insurances
MIPCT Success Story 162 year old female3 IP and 7 ED visits in preceding 12
monthsUCIDDM, CHF, COPD, O2
DependentInattentive Family
MIPCT Patient 1 Plan/SuccessMonthly PCP and Care Manager
MeetingsEducation re: signs and symptoms,
impending troublesLearned to anticipate illness and
contact PCP1 IP stay and 2 ED visits in last 12
months
MIPCT Success Story 228 year old female>25 ED visits preceding 12 monthsMany ED visits via ambulanceMinor medical historyAll ED visits were primary care
sensitive
MIPCT Patient 2 Plan/SuccessAccess to Complex Care ManagerMeetings every two weeksCalls from Care Manager each ED
visitClose working between PCP and
Care Mgr.3 ED visits in last 12 months
Questions?