Wednesday, January 04, 2006

RHIOs and the Emergency Department

One of the challenges to hospitals and emergency rooms is the  “court of last resort” syndrome.   Patients who have lost insurance or are chronically uninsured due to unemployment, ineligibility for Medicaid programs, or high risk illnesses resort to using the emergency room for acute care of non emergent conditions.  In many cases this is  preferable to their not being treated at all.  Hospitals have often subsidized these patients from their other revenues, but in many cases this has become impossible without risking the overall welfare of the financial institutions.

A RHIO may afford some capacity to ameliorate these issues with better communication between hospitals, ambulatory  public health clinics and providers who will accept   non insured patients.  Hospitals may be willing to underwrite parts of the RHIO cost to provide this service to the emergency department, thereby lessening their individual burden.  As the crisis has deepend more and more hospitals have closed their emergency room doors, transferring additional load to still functioning emergency rooms.

Nearly instant communication is  important, so that patient service can be improved.
A linkage between area public health clinics and urgent care and emergency rooms
Regionalized by zip code would give patients and providers the ability to locate medical care for non emergent conditions.  This would provide an efficient means of maximizing the use of public health facilities which are designed to serve underinsured, indigent and/or uninsured patients.  A RHIO would also provide instant notification of a change of eligibility across different payor platforms, including medicare and Medicaid.   The system must be totally integrated to afford these maximum benefits.

San Diego California RHIO is well along in this process with the activation of their   portal now partially operative.

In the next 30 days the Inland Empire Regional Health Information Portal will become active.  The domain name will be announced shortly.  Stay tuned to this blog.


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