At a glance

Client: Voices of Detroit Initiative

Problem: Reducing the use of Emergency Department resources

Solution: Encompass MCR was the solution

Results: Inappropriate use of Emergency Department resources reduced by 30% annually!

About the Client

VODI is a collaboration of partners which include:

- City of Detroit Department of Health and Wellness Promotion
- Wayne County Health Department
- Henry Ford Health System
- St. John Health
- Detroit Medical Center
- Oakwood Healthcare System
- Wayne State University School of Medicine
- Detroit Wayne County Health Authority
- Wayne County Community Mental Health Agency
- Federally Qualified Health Centers: Community Health & Social Services (CHASS), Covenant Community Care, Detroit Community Health Connection, Advantage Health Centers, Health Centers Detroit Medical Group, Wellness Plan Health Centers, Western Wayne Family Health Center
- Free Clinics: Mercy Primary Care, St. John Community Health

Challenges & Goals

America’s Health Care Crisis - There are a number of global issues that have contributed to the current crisis in healthcare. Among these is the fact that there is no system in place to deal with the rising tide of uninsured. Instead there is a patchwork of programs that have been put in place at city, county and state levels which all contributes to a marked disparity in access to care and the resultant outcomes. The "Safety-Net" for the uninsured is fragmented and the number of uninsured is growing at an alarming rate during a period in our history where there are unprecedented constraints on public funding. Due to these constraints, Federally Qualified Health Center clinics that serve the uninsured and under-insured patient population are under staffed, making it difficult for patients to get an appointment with a primary care physician in a timely manner.

Patient Care Model - The patients that do not have access to primary health care will typically put off seeing a physician until their condition worsens to the point that they can no longer ignore their situation. The other situation is the patient that understands that the emergency departments at the hospitals in the area are obligated to treat them regardless of their ability to pay for service. In both cases, these patients stress the resources of the hospital emergency departments. In the city of Detroit, for example, there are more than 200,000 uninsured and the capacity to provide primary care health service will handle only 48,000 people. And, according to the U.S. Census Bureau’s Income, Earnings and Poverty Report from the 2004 American Community Survey (issued August 2005), Detroit has the highest poverty rate of any U.S. city.

The Challenge - identified among the safety net system is the absence of an integrated technology that cuts across the myriad number of health care providers to deliver an integrated medical record that will improve the coordination of care for the uninsured and Medicaid covered patient population.

Solution

The Encompass Medical system has accomplished an all encompassing integration between health care systems, clinics and providers and established a central data collection capability that is driven with a common set of data elements. These data elements are shared among the participating providers which allows all participants to be able to track patient services and avoid duplication of services as well as possible misdiagnoses. The platform provides: 1) a standard eligibility and registration process; 2) practice management interface; 3) electronic medical record interface; 4) comprehensive reporting and patient trending data; 5) a central data collection with common data elements shared throughout the community.

Results

Between 1999 and 2004 approximately 36% of the patients that we enrolled in the program were kept out of the local emergency departments of the hospital systems and successfully transitioned to primary care settings. The monetary benefit translated into $20.7 million in savings to the health systems.