Five Ways Health Navigation Helps Stave Off a Trip to the ER
As we get older, many of us start accumulating underlying issues that make us more vulnerable to a healthcare crisis. Having someone to help you navigate those issues and your care goes a long way toward preventing you from winding up in an emergency room.
We will discuss this more common path to the ER below. However, first we draw attention to our deep belief in preventative care, including care navigation, in avoiding potential trips to the emergency room. Care navigation, like the type offered by ShadowNurse, is a key component to individual healthcare journeys that may help folks avoid preventable trips to the ER all together.
A Common Path to the ER
Maybe you’re in your late 60s dealing with high blood pressure, heart disease or diabetes. Maybe you’ve been discharged after a surgery or cancer care. You have instructions from your doctor to follow and medication to use but juggling those instructions, especially when new issues pop up, can quickly make everything so much more complicated. New symptoms might emerge. Complications related to your medicine or even a simple cold or flu could ramp up a manageable condition into something that needs urgent attention.
Here’s a sobering statistic: according to data from the Centers for Medicare and Medicaid Services, Medicare beneficiaries with six or more chronic conditions had roughly a 25 percent, 30-day readmission rate compared with about 19 percent overall. This hospital readmission is likely with greater multimorbidity.
So what do you do to avoid a readmission or a medical emergency that sends you to the emergency room? What are the resources available for you to avoid that kind of crisis?
A little healthcare navigation support, like the services provided by ShadowNurse or from Medicare’s Chronic Care Management program, reduces the rate of hospital readmissions.
Healthcare navigation at home is a critical layer of support that is often overlooked, but that’s changing. Research on the impact of care coordination, such as point-of-care case management or transitional care management services, demonstrate reductions in 30-day readmissions by 20-30 percent or more in studied populations compared to traditional care.
As a result, fewer patients wound up in critical health emergencies and additionally, those patients experienced substantial savings. Medicare estimates that it saves $74 per patient per month, or about $888 a year, through its Chronic Care Management services, primarily from decreased hospital care needs.
Help with Medication Management
Here’s one of those stunning statistics: up to half of hospital readmissions among those with chronic disease are due to improper use of medication, according to data from the National Institutes of Health.
That’s largely because those with many overlaying conditions are juggling a complex mix of medication to manage those conditions. These are often prescriptions from many different doctors, and it can lead to confusion about timing of a dose, or interactions between different medications, and even side effects.
There are some simple solutions for that and Medicare’s Chronic Care Management program includes dedicated medication management services. ShadowNurse, too, can help caregivers and patients ensure they’re taking the right medications at the right time and the right dose. ShadowNurse’s are also able to address questions about side effects. These kinds of medication management services have a modest improvement in adherence to prescription guidelines by up to 9 percent.
Healthcare navigators like those with ShadowNurse can help review medications, identify potential interactions, and create clear and simple medication schedules for patients. If an issue pops up, these navigators provide same day access to urgent questions before they become issues that land a patient in the ER.
Coordinating Care
Patients with multiple conditions are often seeing many different doctors, and those doctors may not be talking to each other. In many cases, there is no one on the provider side who coordinates that care whichcan lead to redundancies and conflicting treatment plans.
That lack of coordination can be dangerous. That’s why Medicare’s Chronic Conditions Management service includes a strong emphasis on continuous coordinated communication and nurse-led care management. One early demonstration study showed that the service reduced hospital admission by 20 percent and reduced ER visits by 13 percent.
ShadowNurse puts that same kind of emphasis on coordinated care, which can help reduce ER visits and hospital readmission. Care coordination offers a central hub for all provider information, ensuring that test results, treatment plans and medication changes are communicated across the entire care team, including family members, and they can help ensure that follow-up appointments aren’t missed.
Care Navigators Catch Problems Before They Escalate
Trained to recognize how to prevent a manageable chronic condition from becoming worse, Care Navigators know how to discern the warning signs that patients often miss. It's one reason that consistent monitoring, even asking questions about seemingly minor issues, can stave off a visit to the ER.
For example, Medicare research has shown that discharged patients with congestive heart failure, an underlying chronic condition in patients that have the highest readmission rates, who receive remote monitoring or Telehealth care, are much less likely to wind up back in the hospital and, most importantly, have much lower mortality.
One healthcare system, Frederick Health, found that using Medicare's Chronic Care Management service reduced hospital readmissions by 83 percent and saved an estimated $5.1 million.
The big takeaway is that regular, simple remote check-ins with patients, whether through Medicare's Chronic Care Management service or healthcare navigators like ShadowNurse, make a huge difference. That's because they have the training to recognize when even subtle changes in a patient's symptoms or vital signs are red flags for something more serious, allowing these experts to recommend the right steps to prevent something small from becoming urgent.
Access to Answers Prevents Panic-Driven ER Visits
Many people wind up in the emergency room for non-urgent issues simply because they don't know where else to go for care.
Many ER visits are for non-emergency issues, some estimates suggest as many as a third of visits ,but many patients don't know where else to turn for help. This is where Medicare's Chronic Care Management services, or access to health navigators like those provided by ShadowNurse can help again.
By providing an always-on care team, these services offer patients a place to go and help them discern whether an issue is an emergency. These professionals can help triage symptoms, answer questions, and determine the right level of care, whether that's a true emergency or something better handled in an urgent care setting, a doctor's office, or by an on-call nurse over the phone.
Preventing an unnecessary ER visit saves time and money and, most importantly, can help lower a patient's anxiety.
A Personalized Care Plan for Better Outcomes
True healthcare is personal, but patients often get one-size-fits-all instructions, whether in provider interactions or discharge instructions. If you have multiple underlying conditions, those general guidelines might not work.
That’s why a care plan that’s structured to consider those specific conditions and that’s more personalized is both more effective and more likely to be followed. Medicare’s Chronic Care Management service requires the creation of a comprehensive, personalized care plan, something many care navigation services, like ShadowNurse, also provide. These plans must address all the underlying chronic conditions and be tweaked as those conditions evolve.
Starting with the creation of a personalized plan that simplifies complex medical recommendations into easy-to-understand, actionable steps improves engagement and effectiveness. By maintaining regular contact with patients, navigators can adjust plans based on patients' progress.
The Takeaway on Healthcare Navigation
Instead of reacting to an emergency, the best approach is to prevent one in the first place, and the healthcare system is increasingly shifting toward tools for this kind of proactive care.
Healthcare navigators are key to this new, more personalized, value-based, and preventative approach.
For years, patients and caregivers have felt alone in carrying the burden of care without much support; that’s changing. Medicare’s push toward using Chronic Care Management services, as well as services like those provided by ShadowNurse can help usher in this new era.
You are not alone. You can learn more about what ShadowNurse has to offer you here, and remember, the best ER visit is the one that is never needed.