An update from the Wilderness Health Board provided some interesting statistics and information for the North Shore Health hospital board at its Thursday, September 15 meeting.
Cassandra Beardsley, executive director of Wilderness Health (WH), said, “Our rural setting creates both challenges and opportunities as we look to identify potential gaps in care and patients that can benefit from care coordination.”
Members in Wilderness Health include North Shore Health in Grand Marais, Bigfork Valley Hospital in Bigfork, Community Memorial in Cloquet, Lake View Hospital in Two Harbors, Mercy Hospital in Moose Lake, Rainy Lake Medical Center in International Falls, Cook Hospital in Cook, Fairview Range in Hibbing, and St. Luke’s Hospital in Duluth.
Wilderness Health was formed in 2014 as a nonprofit collaborative of independent medical providers located in Northeast Minnesota to, as Beardsley explained, “Advance patient and community health outcomes, improving the patient experience and lowering [patient] costs.”
Beardsley reported that across the region emergency room visits have been on the rise since the start of the new year, and patient visits in general across the nine member hospitals are up 1,408 over a six month time period when compared to the same period last year.
One patient alone made 93 emergency room visits and accumulated 1,400 health care claims during the last 12 months, visiting many health care providers over that time span.
“We’re working with the county to see if there are some social determinants of health (stable housing, food, poverty, etc.) impacting this patient’s utilization of care as they average a visit to a healthcare provider every third day,” said Beardsley.
Spending on prescription drugs continues to be the highest category of service for patients with $15.5 million spent, despite the fact that 91 percent of the drugs that are distributed to patients are generic.
As far as emergency room visits to North Shore Health (NSH), visits are down slightly in 2016, said NSH Administrator Kimber Wraalstad.
“Our ER visits increased in 2014 from 2013 ER visits and then increased again in 2015,” said Wraalstad. “The projected number of ER visits in 2016 is a decline of approximately 100 visits from 2015. Our ER volume generally ranges from 1,900 to 2,200; we have a very small volume compared to some of the other Wilderness facilities [i.e. St. Luke’s].”
While some health care organizations band together in an attempt to get lower prices on goods and services, that isn’t the emphasis behind Wilderness Health, said Wraalstad.
“The focus has been how can we [Wilderness members] work with patients so they are getting the care in the best locations possible [physician office rather than the ER].
“Wilderness isn’t a group purchasing organization; it is more focused on care delivery and identifying best practices,” Wraalstad said. “At this time, our participation has been limited but we have been using some of the best practices being developed and I would think we would all be interested in any strategies to address the expectations of patients who continually ask for antibiotics, and that does happen here.”
To help stem the tide of patients who continually demand antibiotics, WH formed an emergency room subcommittee, consisting of ER physicians, an urgent care physician and a care coordinator, and they are currently seeking to add one to two primary care physicians to the committee.
“This group is looking at some of the ER claims data and identified that a large number of children are being brought to the ER within hours of becoming ill with colds or ear aches and parents are demanding immediate-antibiotics,” said Beardsley. “This group will look at opportunities to educate the public about best practice treatment, overuse of antibiotics and when to seek ER care versus other levels of care. Another issue the group is reviewing is the volume of patients that use the ER for regular care and have no indication of a primary care home.”
While North Shore Health isn’t a big player, said Wraalstad, she added that it’s important for NSH to be involved with the larger organization to meet Medicare requirements.
Wilderness Health was formed to help rural hospitals cope with challenges that can arise when asked to provide care in small communities, especially when there are limited resources available.
“The nine members of Wilderness Health work collaboratively to share best practices and coordinate patient care, which is not always feasible working alone,” said Beardsley, adding, “By working together we can help ensure patients that their care will continue to be in their local community, just like it always has been.”
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