As more people continue to become insured under health care reform, Emergency Department utilization will likely increase and along with that growth, will be the need for better coordination between ER and primary care physicians. While provider collaboration is critical to patient outcomes, The Center for Studying Health System Change found that poor communication between these two provider groups is typically the norm and can lead to duplicative and misapplied treatments.
Scenarios like this are all too common. With limited or no patient information, medications that a patient cannot tolerate may be prescribed, admissions can occur for conditions that are a patients' new “normal”, duplicative tests may be ordered and ED discharge follow up care may be compromised.
Clinical Communication Barriers Between ER and Primary Care Physicians
Several areas contribute to the communication breakdown between ER and primary care physicians:
•The primary mode of communication between physicians is by telephone. The successful completion of a telephone call requires multiple pages and lengthy waits for callbacks ultimately increasing length of stay in the ED.
•Physicians have little confidence in faxed documents because they often are not carefully reviewed by their intended recipient and records are poorly organized and difficult to decipher.
•Sharing simple reports is difficult due to the reality that the majority of PCPs are on separate EMR platforms from hospital-based physicians. The lack of interoperability is a huge barrier.
•ER physicians and PCPs cite insufficient time and lack of reimbursement related to the enormous burden and sheer number of phone calls.
•With the rise of larger group practices and cross- coverage models within those practices, ER physicians are less likely to speak with a physician that has direct knowledge of the patient, yielding little insight or recommendations that would improve an ER physicians' plan of care. (1)
How Can Communication Between ER and Primary Care Physicians Be Improved?
With the increasing utilization of emergency departments for emergent and non-emergent care, there is an imminent need to improve communication and coordination between emergency and primary care physicians.
IM Your Doc is an encrypted, secure, HIPAA compliant platform that allows ER physicians and PCPs to share, in real-time, PHI, images, documents and encounter notes, all on their mobile devices and desktops, through the speed and convenience of text.
For further information on IM Your Doc, visit www.imyourdoc.com or call 1-800-409-8078
1. National Institute for Health Care Reform, Research Brief No. 3, February, 2011