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
Sanjeev Sharma Joins November 11-13, 2018 @DevOpsSummit at @CloudEXPO New York Faculty. Sanjeev Sharma is an internationally known DevOps and Cloud Transformation thought leader, technology executive, and author. Sanjeev's industry experience includes tenures as CTO, Technical Sales leader, and Cloud Architect leader. As an IBM Distinguished Engineer, Sanjeev is recognized at the highest levels of IBM's core of technical leaders.
SYS-CON Events announced today that IoT Global Network has been named “Media Sponsor” of SYS-CON's @ThingsExpo, which will take place on June 6–8, 2017, at the Javits Center in New York City, NY. The IoT Global Network is a platform where you can connect with industry experts and network across the IoT community to build the successful IoT business of the future.
IoT is rapidly becoming mainstream as more and more investments are made into the platforms and technology. As this movement continues to expand and gain momentum it creates a massive wall of noise that can be difficult to sift through. Unfortunately, this inevitably makes IoT less approachable for people to get started with and can hamper efforts to integrate this key technology into your own portfolio. There are so many connected products already in place today with many hundreds more on the h...
DXWorldEXPO LLC announced today that Kevin Jackson joined the faculty of CloudEXPO's "10-Year Anniversary Event" which will take place on November 11-13, 2018 in New York City. Kevin L. Jackson is a globally recognized cloud computing expert and Founder/Author of the award winning "Cloud Musings" blog. Mr. Jackson has also been recognized as a "Top 100 Cybersecurity Influencer and Brand" by Onalytica (2015), a Huffington Post "Top 100 Cloud Computing Experts on Twitter" (2013) and a "Top 50 C...
When applications are hosted on servers, they produce immense quantities of logging data. Quality engineers should verify that apps are producing log data that is existent, correct, consumable, and complete. Otherwise, apps in production are not easily monitored, have issues that are difficult to detect, and cannot be corrected quickly. Tom Chavez presents the four steps that quality engineers should include in every test plan for apps that produce log output or other machine data. Learn the ste...
The best way to leverage your Cloud Expo presence as a sponsor and exhibitor is to plan your news announcements around our events. The press covering Cloud Expo and @ThingsExpo will have access to these releases and will amplify your news announcements. More than two dozen Cloud companies either set deals at our shows or have announced their mergers and acquisitions at Cloud Expo. Product announcements during our show provide your company with the most reach through our targeted audiences.
Enterprises are universally struggling to understand where the new tools and methodologies of DevOps fit into their organizations, and are universally making the same mistakes. These mistakes are not unavoidable, and in fact, avoiding them gifts an organization with sustained competitive advantage, just like it did for Japanese Manufacturing Post WWII.
When building large, cloud-based applications that operate at a high scale, it's important to maintain a high availability and resilience to failures. In order to do that, you must be tolerant of failures, even in light of failures in other areas of your application. "Fly two mistakes high" is an old adage in the radio control airplane hobby. It means, fly high enough so that if you make a mistake, you can continue flying with room to still make mistakes. In his session at 18th Cloud Expo, Le...
DevOpsSummit New York 2018, colocated with CloudEXPO | DXWorldEXPO New York 2018 will be held November 11-13, 2018, in New York City. Digital Transformation (DX) is a major focus with the introduction of DXWorldEXPO within the program. Successful transformation requires a laser focus on being data-driven and on using all the tools available that enable transformation if they plan to survive over the long term.
With more than 30 Kubernetes solutions in the marketplace, it's tempting to think Kubernetes and the vendor ecosystem has solved the problem of operationalizing containers at scale or of automatically managing the elasticity of the underlying infrastructure that these solutions need to be truly scalable. Far from it. There are at least six major pain points that companies experience when they try to deploy and run Kubernetes in their complex environments. In this presentation, the speaker will d...
Machine learning provides predictive models which a business can apply in countless ways to better understand its customers and operations. Since machine learning was first developed with flat, tabular data in mind, it is still not widely understood: when does it make sense to use graph databases and machine learning in combination? This talk tackles the question from two ends: classifying predictive analytics methods and assessing graph database attributes. It also examines the ongoing lifecycl...
Daniel Jones is CTO of EngineerBetter, helping enterprises deliver value faster. Previously he was an IT consultant, indie video games developer, head of web development in the finance sector, and an award-winning martial artist. Continuous Delivery makes it possible to exploit findings of cognitive psychology and neuroscience to increase the productivity and happiness of our teams.
CloudEXPO New York 2018, colocated with DXWorldEXPO New York 2018 will be held November 11-13, 2018, in New York City and will bring together Cloud Computing, FinTech and Blockchain, Digital Transformation, Big Data, Internet of Things, DevOps, AI, Machine Learning and WebRTC to one location.
Andrew Keys is Co-Founder of ConsenSys Enterprise. He comes to ConsenSys Enterprise with capital markets, technology and entrepreneurial experience. Previously, he worked for UBS investment bank in equities analysis. Later, he was responsible for the creation and distribution of life settlement products to hedge funds and investment banks. After, he co-founded a revenue cycle management company where he learned about Bitcoin and eventually Ethereal. Andrew's role at ConsenSys Enterprise is a mul...
Digital transformation has increased the pace of business creating a productivity divide between the technology haves and have nots. Managing financial information on spreadsheets and piecing together insight from numerous disconnected systems is no longer an option. Rapid market changes and aggressive competition are motivating business leaders to reevaluate legacy technology investments in search of modern technologies to achieve greater agility, reduced costs and organizational efficiencies. ...