On a Saturday night, the Emergency Department is full of patients. Alcohol overdoses, injuries, sickness, you name it. On a typical evening, several of these patients fit into a category commonly referred to as “super utilizers” or “frequent fliers”. These patients are a small subset of the population of the United States, but they have high-needs and are extremely high-cost patients [1].
There is a complex combination of issues that brings these patients repeatedly to the hospital. Many have chronic illnesses and need emergency medical treatment far more frequently than the average patient; others are homeless and seek shelter. Other still possess substance abuse or mental health issues that repeatedly drive them to seek medical treatment.
A typical ED is designed to treat medical or psychological emergencies, but many ED’s are inadequate at treating the numerous other kinds of emergencies that enter through their doors. While finding other ways of helping these patients is not necessarily the duty of the hospital, it is ethically problematic to release patients without at least working to treat conditions, medical or non-medical, that consistently result in their return to the ED.
Healthcare Hotspotting is a brilliant new project started in Camden, NJ that aims to strategically use data to “reallocate resources to a small subset of high-needs, high-cost patients”[2]. This new project aims at holistic care and attends to non-medical needs that often cause problems in super utilizer populations e.g. housing, mental health, substance abuse and emotional support [2].
Essentially, this program aims to provide super utilizers and other patients with complex needs with the care they need, whether or not this care is strictly medical. Leaving these complicated patients without resources to fend for themselves outside of the hospital is a failure of our healthcare system, and programs like Healthcare Hotspotting are working to ensure the ethical treatment of these patients, many of whom are voiceless and disheartened.
In addition to providing important care to these patients, programs such as this one also have many other potential benefits. For example, these patients are among the most costly patients in the US healthcare system [1]. Providing them with the care they need could ultimately result in their utilizing hospital resources less frequently and thus could save the healthcare industry money.
Healthcare Hotspotting is a relatively small enterprise, but it sets an interesting precedent. To link healthcare with social work and other services in order to meet the holistic needs of patients is a very worthwhile goal for hospitals and healthcare centers around the country.
References
1. Batal, Holly, et al. "Super-utilizers- Contemplating what counts." Healthcare: The Journal of Delivery Science and Innovation, 22 Nov. 2017.
2. Camden Coalition of Healthcare Providers. "Healthcare Hotspotting." Healthcare Hotspotting: A Project of the Camden Coalition of Healthcare Providers.