权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Improving Mental Health Outcomes with the Emergency Department Information Exchange (EDIE): Insights from Washington State

通过急诊科信息交换 (EDIE) 改善心理健康结果：来自华盛顿州的见解

基本信息

批准号：
9805962
负责人：
Amber Kathleen Sabbatini
金额：
$ 36.03万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-08 至 2022-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9805962
关键词：
Accident and Emergency department Acute Address Alcohol or Other Drugs use American Hospital Association Area Behavioral Caring Case Management Case Mixes Characteristics Clinical Communities Data Data Sources Development Disabled Persons Effectiveness Emergency Department evaluation Emergency Situation Emergency department visit Emergency medical service Goals Health Health Resources Health system Healthcare Hospital Administrators Hospitalization Hospitals Impact evaluation Infusion procedures Link Medicaid Mental Health Mental Health Services Mental disorders Methodology Methods Modeling Outcome Outpatients Patient-Focused Outcomes Patients Physicians Policies Population Process Measure Provider Psyche structure Quality of Care Recommendation Reporting Resources Statutes and Laws Substance Use Disorder Surveys Testing Time Translating Vendor Washington Work authority care coordination care costs care delivery care outcomes cost effective data sharing design experience financial incentive follow-up group intervention improved improved outcome innovation insight medication compliance multiple chronic conditions novel patient population patient subsets programs public-private partnership service engagement trend uptake

项目摘要

PROJECT SUMMARY The overall goal of this study is to understand how health information exchange can be leveraged to improve outcomes for Medicaid patients with mental illness. Mental health-related ED visits have increased by more than 50% in the past decade, with Medicaid absorbing the majority of the associated acute-care costs. Medicaid patients with mental illness often experience fragmented care and poor outcomes, including high rates of preventable ED visits and hospitalizations, compared to those without mental illness. Consequently, reducing preventable hospital use has been a central goal of state Medicaid agencies. Patients with frequent use of emergency services are key target group for interventions to improve care delivery, yet their clinical needs are profoundly different from other patients - over half have a mental health or substance use disorder, more than a third have multiple chronic conditions, and 65% are disabled. Health information exchange (HIE) is a promising strategy to facilitate care coordination for these high-needs Medicaid patients. In 2012, Washington state mandated all hospitals to implement and strategically use an HIE referred to as the Emergency Department Information Exchange (EDIE) as part of its “ER is for Emergencies” program. EDIE was designed to assist hospitals with identifying frequent users of emergency services, facilitate the active development care plans and case management for high-needs patients, and improve data sharing between outpatient providers and hospitals. The use of EDIE, especially the development of electronic care plans, is supported by a variety of policy levers and financial incentives to hospitals, as well as a public-private partnership that makes recommendations for ongoing improvement at the state-level. Yet, to date, its impact on patient outcomes has not been systematically evaluated. Despite this, EDIE and similar HIE platforms are currently being rolled-out in several other state Medicaid programs. Thus, the proposed study aims to understand whether and how EDIE has improved mental health outcomes for frequent users of the ED in Washington state. Using longitudinal Medicaid claims linked to a variety of administrative data sources on hospital and community characteristics we will 1) examine trends in the uptake of EDIE across hospitals, 2) determine the extent to which EDIE improved mental health outcomes for patients overall as well as key subgroups of patients with mental illness, and 3) determine the extent to which health system characteristics enhance the effectiveness of EDIE. The proposed work will contribute to our understanding of the effectiveness of HIE-facilitated care coordination, including the populations, hospitals, and communities that are most likely to reap benefits.

项目总结