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An industry-led pilot program created by the Chamber of Commerce Hawaii and the University of Hawaii has achieved a 62% reduction in emergency room visits in its first year.
The program, which was made successful through its ability to convene public and private stakeholders, was a result of partnership with health care industry leaders at The Queen’s Medical Center and Kalihi-Palama Health Center.
“As a community, we all have a role to play in addressing pressing issues, including homelessness,” said Sherry Menor-McNamara, Chamber of Commerce Hawaii president & CEO. “The outcome has been more industry leaders working together to identify common issues. When we all talk to each other, it’s much more effective.”
The Systems Integration Committee of about 12 industry members brought together health care partners to form its first cohort in 2018, targeting the population that frequents emergency rooms, and drive unnecessary and expensive health care costs.
The first group, Cohort A, included 17 people with a total of 145 visits in the baseline period. For this group, emergency room visits dropped from 145 to 55 — a 62% reduction in visits.
Cohort B was established one month later and included 18 people with a total of 88 emergency room visits in the baseline period. Cohort B’s visits dropped from 88 to 25 — an almost 72% reduction in visits.
Both cohorts took part in interventions that included identification, engagement, motivational interviewing, education, collaboration and care coordination — with the goal being to get the patient to seek and access care in an efficient manner.
“We’re taking care of a need before it becomes a critical need,” explained Dr. Emmanuel Kintu, CEO of Kalihi-Palama Health Center. “We must identify people, identify our resources and identify how to engage with a primary care physician.”
Kintu gave the example of a homeless patient who required three shots of insulin a day and often visited the emergency room for care. By assessing the problem outside of the patient’s physical needs, health providers realized that the woman needed a refrigerator to keep the medication stored, and were able to connect her with a primary care physician who would give her an appropriate level of care.
“We’re looking at the whole person, and some of that is social determinants of health, but another part is getting that quick connection to a primary care physician and identifying avoidable emergency room utilization,” Kintu said.
Menor-McNamara says the long-term goal of the program is to continue addressing these issues collectively, building a talent pipeline for different industries, and offering better care that ultimately leads to health cost savings