This resource describes an effort to apply a learning health systems approach to reducing ED utilization.
- A learning health system focuses on improving people’s health at scale through continuous cycles of knowledge discovery and implementation of best practices.
- This study developed a predictive model to harness data from three Michigan health systems and identify residents at highest risk for future ED utilization in order to more effectively target a care coordination intervention.
- The intervention consisted of steps including entry of data into a care management electronic health record (EHR), a needs assessment, and care plan development.
- The model was able to accurately predict the number of ED visits during the subsequent six months to within a quarter to a half of a visit.
- Transforming care coordination from a reactive to a proactive activity has potential to reduce ED utilization and therefore reduce costs.
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Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
- How can a learning health systems approach reduce emergency department (ED) utilization?
- How can a health system shift from a reactive to a proactive approach to care coordination for heavy ED utilizers, and what are the benefits?
Level of Evidence
ModerateWhat does this mean?