Dramatic Increase In Detroit's Uninsured

The number of uninsured patients that are showing up in the healthcare system in Detroit has grown dramatically over the last few months. At the present time the Voices of Detroit Initiative is collecting data from each of the Federally Qualified Health Center clinics in Detroit, as well as from the St. John Health System and Detroit Medical Center. (Henry Ford Health System and Oakwood are not currently providing patient data to the Voices of Detroit Initiative.) At the beginning of 2009 there was data available on approximately 500,000 patients in the VODI database. The number of patients in the VODI database has been growing at a pretty steady pace over the last ten years and as recently as 3 years ago, there were less than 50,000 uninsured patients in the database. Since the first of the year (2009) the number of uninsured patients in the VODI database has increased to in excess of 1 million patients!

Patient Management

The patients that present for care at the Emergency Department of the hospitals that participate in the VODI system are typically assigned to a clinic for their follow up care. These clinics are usually associated with or owned by the hospital. If patients require follow up with a specialist, the hospitals or clinics will usually make arrangements. (In the instance of Henry Ford Health System, all of the physicians work directly for the hospital. This means that all referrals are handled internally and all costs are written off within the scope of the hospital processes. In most of the other Detroit hospitals, referrals to specialists must be negotiated since those physicians are not under direct contract with the hospital systems where they have privileges.)

The Challenge

The challenge for the Detroit hospital systems and clinics is to manage a dramatic increase in patient loads without any increase in the number of providers. That means that the clinics and hospitals need to be able to move patients through the diagnostic interval and treatment process in a much more effective manner as their individual work loads virtually double.

The Solution

The Encompass Medical system provides an established central data collection point for the clinics and hospitals in the Detroit area. This centralized data source helps providers avoid duplication of services and helps the providers quickly identify patient issues that might otherwise go unnoticed since these patients are not insured and therefore do not enjoy the same type of an ongoing health profile that is available to an insured person.

The Benefit

Uninsured patients typically have a higher incidence of transient movement from clinic to clinic and hospital system to hospital system. Since they are uninsured, there is very little sharing of information on these patients. To further underscore the disparity that exists, each of the clinic systems has their own island of patient data that is held on disparate data systems that do not communicate with other data systems within the local community.

The Encompass Medical System corrects this situation by amassing data from each of the systems that are in place and then makes this data available through a common interface. This helps reduce the incidence of duplicated services; reduces the potential of not seeing an existing condition that has already been diagnosed; reduces the potential for misdiagnosis and inappropriate treatment plans.