Welcome!

News Feed Item

ERs Have Become Central Staging Area for Acutely Ill Patients

More Complex Care Provided in a Challenging Health Care Environment

WASHINGTON, Dec. 27, 2012 /PRNewswire-USNewswire/ -- Lack of stable medical homes and reduced inpatient capacity are key factors that could be responsible for a shift toward higher billing levels over the past decade in U.S. emergency departments, according to a new report from the New England Journal of Medicine (http://tinyurl.com/d2fnsyh). Changing standards of care and the implementation of electronic medical records are additional potential factors in this shift that is accompanied by increases in higher-complexity, higher paid visits for Medicare emergency patients.

(Logo: http://photos.prnewswire.com/prnh/20100616/DC22034LOGO-d)

Study authors were responding to a recent report by the Office of Inspector General, a watchdog organization of the U.S. Department of Health and Human Services, which suggested a widespread phenomenon of "upcoding" in all specialties, but especially emergency medicine.  Subsequent reports in news organizations, including The New York Times and Washington Post, embellished this assertion with separate analyses and specific examples. The authors of this perspective piece, however, examined a nationally representative sample in order to refine these assertions, and concluded that blaming upcoding alone oversimplifies what is happening.

"Care that used to be provided on in-patient floors is now being done in emergency departments," said Dr. Andy Sama, president of ACEP. "Also, in the past decade, primary care physicians increasingly have sent their patients to the emergency department for more prompt and definitive work-ups. They may simply be seriously concerned, overburdened, or the patient may have complex issues that can't be diagnosed easily in a primary care setting. But this puts the burden of accurate and efficient diagnosing on emergency physicians, which leads to higher complexity, and higher billed visits."

In addition, wider trends in the use of technology in health care play a major role.  According to the report, higher use of diagnostic technology is "magnified" in the emergency department, where physicians have ready access to advanced imaging, such as computed tomography (CT), magnetic resonance imaging and ultrasonography. Further analysis might reveal this also could have an unexpected effect of lowering overall health care costs, because some of these higher paid visits prevent hospital admissions, and hospital admissions are much more expensive than ER visits.

As an example, the report says "technological innovations have revolutionized care for abdominal pain," which is one of the three top symptoms that bring Medicare patients into the emergency department. Now patients with abdominal pain can often be discharged from the ER after a negative CT rather than being admitted to the hospital.

"The world just expects more of us than it used to," said study author Dr. Stephen Pitts, associate professor at Emory University School of Medicine.

The article also directly addresses whether electronic medical records are affecting billing charges. 

"The use of electronic medical records may facilitate increased billing, because they are designed to capture and bill for every single clinical action," said Dr. Pitts. "This has reduced historical underbilling, where emergency physicians wouldn't always accurately capture everything that happened during the ER visit. Of course it also may facilitate increased billing. One reason we may be seeing a steeper trend in ER billing is just that ERs are early adopters of health IT."

ACEP is the national medical specialty 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. 

SOURCE American College of Emergency Physicians (ACEP)

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
SYS-CON Events announced today that Daiya Industry will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Daiya Industry specializes in orthotic support systems and assistive devices with pneumatic artificial muscles in order to contribute to an extended healthy life expectancy. For more information, please visit https://www.daiyak...
SYS-CON Events announced today that Nihon Micron will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Nihon Micron Co., Ltd. strives for technological innovation to establish high-density, high-precision processing technology for providing printed circuit board and metal mount RFID tags used for communication devices. For more inf...
SYS-CON Events announced today that Massive Networks, that helps your business operate seamlessly with fast, reliable, and secure internet and network solutions, has been named "Exhibitor" of SYS-CON's 21st International Cloud Expo ®, which will take place on Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. As a premier telecommunications provider, Massive Networks is headquartered out of Louisville, Colorado. With years of experience under their belt, their team of...
SYS-CON Events announced today that Suzuki Inc. will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Suzuki Inc. is a semiconductor-related business, including sales of consuming parts, parts repair, and maintenance for semiconductor manufacturing machines, etc. It is also a health care business providing experimental research for...
"Our strategy is to focus on the hyperscale providers - AWS, Azure, and Google. Over the last year we saw that a lot of developers need to learn how to do their job in the cloud and we see this DevOps movement that we are catering to with our content," stated Alessandro Fasan, Head of Global Sales at Cloud Academy, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
Enterprises are moving to the cloud faster than most of us in security expected. CIOs are going from 0 to 100 in cloud adoption and leaving security teams in the dust. Once cloud is part of an enterprise stack, it’s unclear who has responsibility for the protection of applications, services, and data. When cloud breaches occur, whether active compromise or a publicly accessible database, the blame must fall on both service providers and users. In his session at 21st Cloud Expo, Ben Johnson, C...
21st International Cloud Expo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading industry players in the world. Cloud computing is now being embraced by a majority of enterprises of all sizes. Yesterday's debate about public vs. private has transformed into the reality of hybrid cloud: a recent survey shows that 74% of enterprises have a hybrid cloud strategy. Me...
Many organizations adopt DevOps to reduce cycle times and deliver software faster; some take on DevOps to drive higher quality and better end-user experience; others look to DevOps for a clearer line-of-sight to customers to drive better business impacts. In truth, these three foundations go together. In this power panel at @DevOpsSummit 21st Cloud Expo, moderated by DevOps Conference Co-Chair Andi Mann, industry experts will discuss how leading organizations build application success from all...
SYS-CON Events announced today that mruby Forum will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. mruby is the lightweight implementation of the Ruby language. We introduce mruby and the mruby IoT framework that enhances development productivity. For more information, visit http://forum.mruby.org/.
Cloud-based disaster recovery is critical to any production environment and is a high priority for many enterprise organizations today. Nearly 40% of organizations have had to execute their BCDR plan due to a service disruption in the past two years. Zerto on IBM Cloud offer VMware and Microsoft customers simple, automated recovery of on-premise VMware and Microsoft workloads to IBM Cloud data centers.
Why Federal cloud? What is in Federal Clouds and integrations? This session will identify the process and the FedRAMP initiative. But is it sufficient? What is the remedy for keeping abreast of cutting-edge technology? In his session at 21st Cloud Expo, Rasananda Behera will examine the proposed solutions: Private or public or hybrid cloud Responsible governing bodies How can we accomplish?
Today traditional IT approaches leverage well-architected compute/networking domains to control what applications can access what data, and how. DevOps includes rapid application development/deployment leveraging concepts like containerization, third-party sourced applications and databases. Such applications need access to production data for its test and iteration cycles. Data Security? That sounds like a roadblock to DevOps vs. protecting the crown jewels to those in IT.
SYS-CON Events announced today that Cedexis will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Cedexis is the leader in data-driven enterprise global traffic management. Whether optimizing traffic through datacenters, clouds, CDNs, or any combination, Cedexis solutions drive quality and cost-effectiveness.
Elon Musk is among the notable industry figures who worries about the power of AI to destroy rather than help society. Mark Zuckerberg, on the other hand, embraces all that is going on. AI is most powerful when deployed across the vast networks being built for Internets of Things in the manufacturing, transportation and logistics, retail, healthcare, government and other sectors. Is AI transforming IoT for the good or the bad? Do we need to worry about its potential destructive power? Or will we...
SYS-CON Events announced today that B2Cloud will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. B2Cloud specializes in IoT devices for preventive and predictive maintenance in any kind of equipment retrieving data like Energy consumption, working time, temperature, humidity, pressure, etc.