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Epic Outcomes

Combating Loneliness to Improve Care and Reduce Costs

Parkland Health & Hospital System reduces unnecessary ED visits by coordinating care and education for its most frequent visitors

Researchers at Parkland Health & Hospital System in Dallas, Texas found an unexpected underlying cause for many of the patients most frequently making trips to emergency rooms in their network: loneliness.

One of Parkland’s frequent ED visitors, Michael, wasn’t necessarily chronically unhealthy—he was usually seeking companionship or advice about minor issues and was unaware that he could seek care at a Parkland clinic closer to his workplace. To help patients like Michael access more convenient and cost-effective care, Parkland reached out to community resources to create a support network that can provide frequent ED visitors with consistent companionship and education.

The organization regularly reassesses its ED visit data in Epic to identify frequent ED visitors and coordinate interventions, such as providing case management through social workers or more proactive treatment for a chronic condition. Results so far have been promising. In Michael’s case, after he was assigned a dedicated social worker, his trips to the ED declined by 70%.

“The number one determinant of high emergency department utilization is relationships,” said Dr. Esmail Porsa, executive vice president and chief strategy and integration officer at Parkland Health & Hospital System. “One day we looked at the data and realized—lo and behold—there were three patients on the top of the list.” Those top three utilizers visited the emergency room a combined total of more than 500 times in one year.

By working with community organizations to provide more effective care outside the ED for these patients, Parkland hopes to reduce patient volume as well as costs. The hospital estimates that these frequent ED visitors cost Dallas County taxpayers around $14 million per year.

Read more about Parkland’s efforts to reduce unnecessary ED visits from WFAA.