ERs Can Improve Population Health in Rural Areas

ACEP Press Release:

Emergency physicians in Michigan propose a new health care delivery model for rural populations that depends on a partnership between emergency medicine and primary care and seeks to reverse the trend of failing health in underserved parts of the country.  Their proposal was published online yesterday in Annals of Emergency Medicine (“An Emergency Medicine-Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine“).

“The traditional urban model of health care has been ineffective at improving rural health,” said the paper’s lead author Margaret Greenwood-Ericksen, MD, MPH of the Department of Emergency Medicine at the University of Michigan in Ann Arbor. “Our emergency medicine-primary care model embraces the role that emergency departments play in providing primary care in rural areas while also connecting patients to other physicians and resources in the community. Rural hospitals can serve as a hub for emergency care, primary and preventive care, and social services for improving rural population health.”

The model proposed by Dr. Greenwood-Ericksen would not replace the existing outpatient rural safety net, comprised of federally qualified health centers and rural health clinics. It would supplement it.

The paper cites Carolinas HealthCare System Anson in Wadesboro, N.C. as an example of a new rural hospital designed to provide both emergency and primary care, calling it “a test of a new model of rural health care delivery.” The final design has no physical walls separating emergency and primary care.

In other communities, similar partnerships could optimize emergency care, meet unscheduled acute care needs, address rural social determinants of health across the care continuum, achieve financial solvency and support public health.

“There is an urgent need for a rural-specific model of care aimed at improving the sharply declining health of rural Americans,” said Dr. Greenwood-Ericksen. “The partnership we propose is novel yet practical and acknowledges that an emergency department might be the closest source of health care for rural patients. Emergency medicine-primary care partnerships can address rural populations’ most pressing social and medical needs.”

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit www.acep.org.

Giving in to providing primary care in the ED

From Modern Healthcare:

For rural healthcare providers, reducing use of the emergency department can determine whether a facility will continue running. With thinner operating margins compared to larger, urban medical centers, rural hospitals often have a higher proportion of ED patients who are uninsured or can’t pay their insurance deductibles, which results in higher rates of uncompensated care for such facilities.

But a proposal published this week in the Annals of Emergency Medicine suggests embracing innovative models like the one at Carolinas may hold the key for improving both the delivery of care and health outcomes for rural communities through use of the emergency department.

“I think in urban areas, efforts to reduce emergency department utilization are extremely important,” said paper lead author Dr. Margaret Greenwood-Ericksen, an emergency medicine physician at the University of Michigan and a researcher at the school’s Institute for Healthcare Policy and Innovation. “But urban and rural areas are very different in many ways—so applying an urban model to a rural area doesn’t really seem to be effective and doesn’t take into consideration some of the barriers that are faced in rural areas.”

Emergency medicine-primary care partnership seeks to improve health of rural populations

From News-Medical:

Emergency physicians in Michigan propose a new health care delivery model for rural populations that depends on a partnership between emergency medicine and primary care and seeks to reverse the trend of failing health in underserved parts of the country. Their proposal was published online yesterday in Annals of Emergency Medicine (“An Emergency Medicine-Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine”).

“The traditional urban model of health care has been ineffective at improving rural health,” said the paper’s lead author Margaret Greenwood-Ericksen, MD, MPH of the Department of Emergency Medicine at the University of Michigan in Ann Arbor. “Our emergency medicine-primary care model embraces the role that emergency departments play in providing primary care in rural areas while also connecting patients to other physicians and resources in the community. Rural hospitals can serve as a hub for emergency care, primary and preventive care, and social services for improving rural population health.”

The model proposed by Dr. Greenwood-Ericksen would not replace the existing outpatient rural safety net, comprised of federally qualified health centers and rural health clinics. It would supplement it.

A new approach to rural healthcare

From Consumer Affairs:

In healthcare, conventional wisdom holds that seeking treatment for a non-emergency condition in a hospital emergency room is both expensive and highly inefficient.

But a plan drafted by emergency physicians in Michigan turns that belief upside down, at least as far as rural communities are concerned.

Their study, published in the the “Annals of Emergency Medicine,” proposes a partnership between the ER and primary care providers to meet unique rural healthcare needs.

This partnership, the authors contend, could reverse the trend of failing health in underserved parts of the country.