Coordinate after-hours care to keep patients out of ER: Study

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Clinicians who want to keep their patients out of the emergency department should develop after-hours clinical arrangements that allow physician notification, sharing of electronic health records and financial support from payers, according to a study.

Researchers from the Center for Studying Health System Change examined five types of after-hour care arrangements offered by U.S. physicians to identify the key elements needed to ensure effective 24-hour access to non-emergency department care by their patients. Such round-the-clock access is key to reducing unnecessary emergency department use, the authors noted, but little guidance is available to primary-care physicians on what such a model should look like. The study, based on in-depth interviews with 44 primary-care physicians, practice managers, nurses and health plan representatives from 28 organizations that provide after-hours care, found that a shared EHR and systematic notification procedures between the after-hours and daytime providers are key to such systems. Also, after-hours care systems work best when adopted as part of a broader primary-care practice strategy that improves access during regular business hours, as well. The researchers also concluded that small practices face the biggest logistical challenges in supporting after-hours care. However, their participation in such initiatives is critical because more than 70% of office visits are to practices with five or fewer physicians.


Coordinate after-hours care to keep patients out of ER: Study