Writ­ten by Frank Tucker

Approx­i­mately 20% of the emer­gency med­ical sys­tem (911) use comes from fre­quent users often linked to chronic care health issues. Account­ing for less than 1% of the pop­u­la­tion of the city, they dis­pro­por­tion­ately drive tax payer ambu­lance, fire fighter and para­medic costs. Pre­hos­pi­tal case man­age­ment may reduceEMS use in high-​frequency EMS users and cre­ate sig­nif­i­cant cost sav­ings to the City and the health care sys­tem. They not only help save money, they help save lives. Not only can case man­age­ment help the patient, it can help free valu­ableEMS resources needed for an already bur­dened sys­tem. Case Man­agers will:

  • Help enroll indi­vid­u­als in health insurance
  • Con­nect indi­vid­u­als to a med­ical home
  • Pro­vide health edu­ca­tion and infor­ma­tion to avoid crises
  • Link indi­vid­u­als to a vari­ety of other ser­vices, includ­ing dis­ease case man­age­ment pro­grams, food pantries, hous­ing, employ­ment, and home­less shelters.

By using case man­agers, we change the entry point to the health care sys­tem of fre­quent users from EMS to coor­di­nated health care. A key com­po­nent to effec­tively man­ag­ing these cases is Case Man­age­ment Soft­ware that takes a patient rela­tion­ship par­a­digm sim­i­lar to cus­tomer rela­tion­ship man­age­ment in busi­ness. Using a med­ical case man­age­ment sys­tem like Micro­Health Case Man­ager can help bring effi­ciency and cost-​effectiveness to your City. HIPAA-​compliant Med­ical Case Man­ager solu­tions like Micro­Health Case Man­ager facil­i­tates the col­lab­o­ra­tive process to help man­age treat­ment plans and ensure the appro­pri­ate med­ical care is coor­di­nated for the dis­abled, ill or injured. Micro­Health Case Man­ager helps keep track of cases, tasks, doc­u­ments, notes, appoint­ments, calls, email, health his­tory and much more. Built on open source, it is highly cus­tomiz­able giv­ing you the max­i­mum free­dom to per­son­al­ize the soft­ware quickly and eas­ily to meet emerg­ing needs.

To ensure max­i­mum effec­tive­ness, case man­agers should look at the patient holis­ti­cally to ensure the appro­pri­ate sup­port sys­tems are in place for long term sus­tain­abil­ity. For exam­ple, though the patient’s health care may be man­aged, they may also suf­fer socioe­co­nomic bur­dens con­tribut­ing to their sit­u­a­tion in total­ity. There­fore, the case man­ager should also help enroll the patient in pro­grams like the United Way to help obtain sub­si­dized hous­ing and pub­lic med­ical pro­grams which is far more cost effec­tive than dial­ing 911. Annals of Emer­gency Med­i­cine study found that pro­grams pro­vid­ing fre­quent users a coor­di­nated array of social and med­ical ser­vices had the poten­tial to save mil­lions in tax­payer dol­lars. How­ever, it’s not only about socioe­co­nom­ics. Annals of Emer­gency Med­i­cine also found that only 15 per­cent of fre­quent users were unin­sured, yet most were still pri­mar­ily call­ing 911. This is as much a cul­tural issue with health unin­formed patients that have com­plex psy­choso­cial needs.

In an era of dwin­dling bud­gets and esca­lat­ing need, it’s time to change the par­a­digm. An esti­mate by San Fran­cisco Gen­eral Hos­pi­tal cited by the study showed that when the hos­pi­tal pro­vided case-​managed, com­pre­hen­sive care to those fre­quent users received 30 per­cent sav­ings. Sim­ply put, it is much cheaper to pro­vide fre­quent users the broad array of assis­tance than leave them in con­stant need of ambu­lances and emer­gency rooms. Based on stud­ies, we esti­mate cities can obtain a sav­ings of approx­i­mately $6231.60 per fre­quent user per year after costs of imple­ment­ing a case man­age­ment inter­ven­tion program.