Helping an ACO Address Total Cost of Care (TCoC) by Avoiding Unnecessary ED Visits


Lack of direct access to specialists was driving up ED evaluations and total cost of care

Wake Key Community Care (WKCC) is an ACO/CIN formed by WakeMed and Key IPA in 2013. With more than 1,000 physicians, WKCC currently manages over 210,000 lives under contract with both commercial and government payers. While WKCC TCoC performance has been exceptional, leadership was seeking method for driving down unnecessary ED visits by improving direct access to on call specialists.

Physician and administrative executives knew that with the ED as such a large cost driver, avoiding even a fraction of those visits would ensure that patients get better care while positively impacting the costs associated with that.

ACO implemented PH Connect to streamline access to on-call specialists and services

WakeMed and WKCC selected PH Connect as its preferred method of doctor to doctor communication. “PH Connect allowed our providers to reach a doctor specifically by name or merely select the on-call provider for a particular service. Not only that, but because PH Connect allows doctors to easily control their availability, the doctors didn’t have to worry about being contacted when they were off duty—it was a win-win situation,” said one physician who participated on the committee evaluating alternative solutions.

Thousands saved per avoided ED visit, improved patient satisfaction and care

A perfect example of ED avoidance happened recently and involved a community-based pediatrician and a pediatric surgeon. Based on patient presentation, the pediatrician strongly suspects an appendicitis. The normal course of action would have been to send the patient to the ED for further evaluation and decision. However, through PH Connect, the pediatrician reached out to the pediatric surgeon on call via secure text, with all the pertinent patient information and requested a call back. Within two minutes, the pediatric surgeon received the message, called back, discussed the case and advised to send the patient directly to patient registration. The child was in surgery within two hours, and released to go home four hours after that.

Thanks to PH Connect, the patient was able to avoid delays in the ED, potential unnecessary tests, delayed after-hours surgery and an overnight stay. On top of that, the pediatric surgeon used PH Connect to relay status back to the pediatrician, enabling follow up the next day. No missed communication, no waiting on hold to find the doctor on call, no faxes communicating patient status — just rapid access to the right doctor with the right information at the right time.

“I was stunned by how smoothly this worked. I knew if the patient was sent to the ED she would end up waiting longer than necessary. PH Connect allowed me and the specialists to communicate about the plan with no hassles. It was best for the patient and gave me peace of mind to know the status of her progress at every step,” said the referring pediatrician.

It is estimated that every avoided ED visit can save thousands of dollars in costs, between potentially redundant testing, the actual ED visit, delays in care and potential admission due to timing and staff availability.

Using PH Connect, across the inpatient and outpatient environment, enables the reduction of total cost of care, and of course, the value of better, expedited, patient care is immeasurable. “