Preventing Emergency Department Visits With Education

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Hospital emergency departments, as the name implies, are meant to be used for true emergencies. Unfortunately many trips to the ER are not life-threatening and are in fact both unnecessary and avoidable. A study published in 2013 found that only 29% of ER visits reviewed were actual emergency situations. Less than half of those visits that were not an emergency required medical attention but could have been treated in a primary care facility. One in four did not require immediate attention.

Low health literacy leads many patients to the ER when they could have received care at a less expensive setting – like at their doctor’s office or at a walk-in clinic. It’s also known that patients with low health literacy are more likely to make return visits to ERs within two weeks. Some barriers for patients with low literacy include:

  • Not understanding or following doctor’s instructions for managing chronic conditions.
  • Misunderstanding information they find about symptoms online.
  • Not recognizing the importance of proper preventative care.

More recent research, presented at the Society for Academic Emergency Medicine Annual Meeting in Orlando, explored how low health literacy was related to preventable ER visits. The study looked at over 1,200 participants and a total of 4,444 ER visits. Over 10% of the visits were found to have been preventable.

Of the preventable visits, over 60% led to hospital admission. (The average cost of a hospital stay is estimated to be close to $10,000.) When researchers looked at the health literacy of the participants, those with lower health literacy were over twice as likely to have made a preventable ER visit. Having below an eighth-grade reading level was the definition used for low literacy.

The most common preventable conditions leading to ER visits included chronic obstructive pulmonary disease (COPD), urinary tract infections and long-term complications from diabetes.

While not surprising, the study illustrates that patients with low literacy are more likely to make preventable visits to ER and other emergency services. And increasing the literacy of patients can help dramatically decrease unnecessary healthcare costs.

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Jerry Gulley currently serves as EdLogics’ Chief Content Officer. He trained at the Culinary Institute of America in Hyde Park, New York and has held positions with Cooking Light, Health, and AllRecipes. 

14 Smart Ways to Save Money on Healthcare

Drowning in medical bills? These tips can help.
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My wife and I are generally pretty savvy shoppers. Well, she is – and I get the benefits. She clips coupons, looks for bargains, and buys certain items only when they’re BOGO (buy one, get one free). Why pay full price when you don’t have to?

In healthcare, we’ve rarely had that option. For a long time, the cost of a healthcare treatment or test didn’t even come up until after the bill came. For most of us, health insurance covered the majority of the cost, and our responsibility was limited to a small co-pay.

That’s changing now as the trend toward consumer-directed health plans (CDHPs) grows, and many of us are spending more out of pocket. In 2016, nearly one-third of all employer-sponsored health plans were CDHPs.

As a result, patients are getting choosier. And as the healthcare system continues to evolve, we need to be more proactive. We need to get smart about where to go for care, how to pay, and how to prepare. These tips can help:

How to Save

Your primary care physician is likely your go-to source for most of your healthcare needs. But there are times you may want to consider these alternatives:

  • Some health plans offer telemedicine, which can give follow-ups, help manage chronic conditions, monitor medications, and provide other clinical services all through electronic communication. Depending on your condition, telemedicine can save you both time and money.
  • For problems that are serious but not life-threatening, such as a sprained ankle, bad cough, or fever, urgent care centers can be a good alternative to the emergency room. Be sure the center is in network for your insurance plan. Co-pays for visits should be listed on your insurance ID card or on the plan’s web portal or mobile app.
  • Websites like FAIR Health may help you figure out the costs of some medical care.
  • Teaching hospitals in some communities may offer discounts for certain medical needs.
  • For prescription drugs, ask your doctor or pharmacist if generic versions are available. They’re often a fraction of the cost of a brand-name medication.

How to Pay

Using credit cards to pay off big medical bills may be tempting, but it can add up to mountains of debt. Make sure you know your options:

  • If you have a high-deductible health plan (HDHP), you can open and put money in a Health Savings Account (HSA) with pre-tax dollars. Many employers will contribute to your HSA as well. HSAs can be used for a wide range of healthcare expenses – from sunscreen to X-rays – and the balance carries over year to year.
  • With Flexible Spending Accounts (FSAs), you can use pre-tax dollars to pay for most healthcare-related products and services. Some FSAs operate on the “use it or lose it” rule, meaning you must spend all the money in your account by the end of each year or lose any remaining balance. There are exceptions, though, so check with your employer.
  • Hospitals and certain providers may consider payment plans for larger expenses. Be sure to ask about them if you anticipate big bills or find yourself with higher-than-expected costs.
  • Finally, keep in mind that most healthcare organizations will take into account your ability to pay. You may be able to negotiate some expenses, or they can suggest programs that can help out.

How to Prepare

Here’s the key to saving on healthcare: Do your homework. Costs for tests, procedures, and treatments can vary widely, regardless of where you live or what plan you use, so take these steps:

  • Choose the right plan based on your age, health history, and the care you expect you’ll need.
  • Be sure your provider is in-network.
  • Talk to others who’ve been through similar medical issues or procedures, and learn from their experiences.
  • Ask questions – not only about what to expect from the service, but about how much it will cost. Healthcare is one of the most expensive services we purchase, so don’t be shy about asking questions whenever your doctor recommends tests or procedures, or prescribes medications.
  • Be proactive: Practice good health habits, eat smart, exercise, and take advantage of free screenings, flu shots, and other preventive steps.

Paying for healthcare will never be like shopping for groceries. But as things continue to change, there will likely be more and more similarities – and in time, smart shoppers will get better deals.

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Frank Hone is a consumer marketing strategist who focuses on the business impact of engagement strategy for health and well-being improvement... read more 

7 Symptoms You Should Never Ignore At Work

Know when to act and what to do
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Not surprisingly, a reported 65% of those US employees with low-paying jobs often go to work sick. The number for professionals and high-income employees is only slightly better at 48%. One risk is that sick and contagious employees will infect their coworkers, leading to a greater decrease in productivity. Even more terrifying, an employee who thinks they may just be suffering from a cold or the flu may come to work and have to deal with an even more serious health event.

Here are 7 symptoms that should never be ignored at work. If you’re not sure if your employee or coworker is dealing with something serious, be safe and don’t wait—call 911.

1. Chest pain doesn’t always mean a heart attack, but don’t take any chances. Some heart attacks come on suddenly, while others start slowly. Get help right away if someone feels a tightness or squeezing in the center of their chest that lasts for a more than a few minutes or stops and comes back again. They may feel pain in your back, neck, jaw, stomach, or one or both arms. They may be short of breath—with or without chest pain—or feel dizzy, sweaty, or sick to your stomach. Call 911 (don’t try to drive yourself is you are having chest pains) if you think someone may be having a heart attack and get the person to the hospital.

2. Sudden shortness of breath. Many types of work can lead to someone feeling out of breath, but sudden shortness of breath for no obvious reason can be a sign of something more serious, like a blood clot in the lungs, collapsed lung, or heart attack. Call 911 if someone you work with can’t catch their breath.

3. Sudden, intense headaches that come on out of the blue are often called thunderclap headaches. The pain usually peaks within one minute. Some people feel faint or sick to their stomach. Many thunderclap headaches are life-threatening, so call 911 right away if someone at work is having one. It could mean dangerous bleeding in or around the brain, or another problem with the brain’s blood supply.

4. Sudden confusion. We’ve all had that where’d-I-just-put-my-keys feeling. But it’s important to call 911 if someone becomes confused rapidly. It could be caused by fever, stroke, low blood sugar, or many other reasons. Watch for cold, clammy skin, faintness or dizziness, a fast pulse, headache, or fast or slow breathing. Check also to see if the confused person has diabetes or has had a brain injury.

5. Sudden or severe belly pain. Most stomach problems like indigestion or gas usually go away in a few hours. But belly pain can sometimes be serious. Take someone to an emergency room if they have severe belly pain, especially if they:

  • could be pregnant
  • also have a fever
  • have pain in the back, chest, neck, or shoulder
  • are vomiting blood or have bloody diarrhea
  • feel stiffness or tenderness in their stomach area

6. Flashes of light. Someone “seeing stars” or light flashes should see a doctor right away. These could be signs of a detached or torn retina, a serious problem that can lead to blindness if it’s not treated early and an especially risky condition to have at work. Some people also see flashes of light before a migraine headache. In very rare cases, light flashes can be a sign of cancer.

7. Signs of stroke. Think F.A.S.T and watch for:

  • Face drooping
  • Arm weakness
  • Speech problems
  • Time to call 911: If someone shows any of these symptoms, call 911 immediately, even if the symptoms stop. The sooner you get help, the better chances the person will have of surviving.
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Frank Hone is a consumer marketing strategist who focuses on the business impact of engagement strategy for health and well-being improvement... read more 

The Healthcare Information and Management Systems Society Annual Conference

Population Health, Engagament and Patient Portals
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The 2017 Healthcare Information and Management Systems Society conference – commonly known as HiMSS –  was another huge conference that covered so much it was a bit overwhelming.  The number of presentations and vendor booths was incredible and the opportunity to review company IT offerings and network was amazing.

Population Health and Engagement were still major buzzwords at this year’s conference and I had the opportunity to review several of the population health management systems developed by major EMR companies and other vendors.

The focus of these platforms was still on registry type information with the ability to drill down for the doctor, nurse care manager or other.  This year many of the vendors highlighted their new dashboards and other graphical interfaces.  In reviewing these systems and speaking with others, we saw little evidence of user-friendly workflows or for that matter, any real attention paid to the patient.

From the patient perspective, while many of the platforms included patient portals that provided data, a communications component and some patient education – these components were not well thought out and clearly not engaging enough to sustain long term interaction.

In a population health based approach, the patient needs to be actively involved and engaged when they are not at the physician’s office. One of the components of this engagement strategy should be a portal with a solid user experience and relevant information. From years of research along with knowledge gleaned from the retail industry, we know what engages and activates people. Based on this knowledge, these portals should include a stronger focus on the look and feel of the site, the overall patient experience and flow, and leverage gamification, games and behavioral economics.

One simple way to “plug and play” these types of feature sets into the patient portal and add prescribed education to population health programs would be to integrate the EdLogics Platform.

The EdLogics platform greatly increases engagement and incentivizes interaction and learning wherever and whenever the patient is available, providing the education needed to change behaviors.

EdLogics Founder and CEO Tom Chamberlain was interviewed at HiMSS. Listen to the interview here.

Learn more about HiMSS.

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Fred Goldstein is the founder and president of Accountable Health, LLC, a healthcare consulting firm focused on population health. He has over 30 years of experience in population health, disease management, HMO and hospital operations. He is an expert in population health, care more