How to Reduce ED and Acute Care Visits with Digital Care Tools

For home health agencies, reducing emergency department (ED) utilization and acute care hospitalizations is an ongoing challenge. These events cause a variety of negative impacts, from Medicare penalties to low patient satisfaction and star ratings, yet many are preventable with the right training and tools.

In this article, we’ll take a look at why potentially preventable ED and acute care visits occur, and how digital care can help reduce the rates of these visits.

Why ED and Acute Care Visits Occur

Under the Home Health Value-Based Purchasing (HHVBP) model, ED visits and hospitalizations are considered adverse events and indicators of potential gaps in care coordination and management. CMS applies penalties when acute care hospitalization and/or ED utilization occurs within 60 days of start of care.

There are a number of reasons for ED and acute care visits, but one thing that most of them have in common is that they’re potentially preventable with the right skills, tools, and processes. Top reasons include:

  • Complications from chronic and non-chronic conditions like heart failure, acute myocardial infarction, COPD, pneumonia, and kidney disease.
  • Medication errors.
  • Impairments in activities of daily living (ADL) function.
  • Poor patient engagement and compliance.
  • Inadequate transitions of care.
  • Incomplete or missing patient education leading to misunderstandings about discharge instructions and care plans.

Did you know? Congestive heart failure (CHF) is the most common cause of rehospitalization in the U.S. for people older than 65 years of age, but proper patient management can reduce the instance by half.1

How Digital Care Can Help

For home health agencies tasked with minimizing costs while improving care quality and clinician competence, digital care is an effective strategy for reducing ED and acute care visits. With a digital care solution that combines patient education, patient engagement, and clinical education tools, agencies can:

Improve Patient Self-Management

According to the World Health Organization (WHO), outcomes for patients with chronic conditions are significantly higher when patients (and their families) take an active role in their care.2 Yet many patients with chronic diseases don’t have the skills or knowledge they need to effectively manage their condition. In order to properly manage their disease and even slow its progression, patients need engaging, easy-to-understand information on their condition and how to manage it.

These digital care tools help improve patient self-management:

  • Digital patient education
  • Online clinical training
  • Online soft skills training
  • Remote digital monitoring
  • Risk stratification

Ensure That Nurses Can Identify Signs and Symptoms

For patients with chronic conditions, taking medications as prescribed isn’t always easy. One day a patient might experience symptoms, but on other days feel good and be tempted to skip doses. To prevent conditions from progressing, home health nurses must recognize warning signs as soon as they arise and ensure that patients are following their prescribed care regimen, regardless of how they’re feeling from day to day.

These digital care tools help boost skill and competency:

  • Online clinical training
  • Online soft skills training

Keep Patients Engaged and Activated Between Visits

Did you know that engaged patients are less likely to visit the emergency room and 30 percent less likely to be readmitted to the hospital following discharge?3 A good digital care program will include a strong patient engagement component that allows agencies to:

  • Create condition-focused templates within an engaging home exercise program.
  • Assign templates based on patient type and condition, from chronic conditions like heart failure and COPD to falls, TJR, and pressure wounds.
  • Efficiently progress patients by updating their program throughout the episode of care to support timely outcomes and patient satisfaction.
  • Leverage telehealth, patient feedback, and messaging to support the patient throughout their care plan.

These digital care tools help improve patient engagement:

  • Home exercise programs
  • Patient adherence tracking
  • Telehealth
  • Patient mobile app or an easy-to-access web portal
  • Remote digital monitoring

Improve Patient Physical Function

Poor patient physical function is strongly correlated with higher hospitalization rates due to factors such as falls and chronic disease progression. Helping your patients keep or gain the functionality needed to successfully perform activities of daily living is essential to reducing acute care and ED visit rates.

These digital care tools help improve physical function:

  • Home exercise program
  • Patient adherence tracking
  • Telehealth
  • Patient mobile app or an easy-to-access web portal
  • Remote digital monitoring

How MedBridge Can Help

The MedBridge digital care platform gives you everything you need to engage patients, improve outcomes, and minimize costs—with no assembly required. It includes:

Home Exercise Program (HEP)
Engage patients with an easily accessible and customizable library with thousands of video exercises developed by industry professionals.

Patient Adherence Tracking
Identify behavioral patterns and barriers to adherence to help boost patient satisfaction and improve clinical outcomes.

Patient Insights
Capture patient insights like pain, difficulty, and perceived progress with surveys and monitoring tools to help build a patient-inspired culture.

Patient Education
Help patients understand their diagnosis and rehabilitation plan with engaging education to encourage them to effectively manage their care plan.

Telehealth Virtual Visits
Replace or supplement in-person visits for low-risk patients with effective, user-friendly telehealth tools.

MedBridge GO Mobile App
Engage patients and promote adherence by prescribing home exercises in easy daily doses and allowing patients to reach out with questions or concerns via two-way messaging.

Provider Education
Provide evidence-based online education and training covering telehealth, patient engagement, soft skills, and more.

  1. Nair R, Lak H, Hasan S, Gunasekaran D, Babar A, Gopalakrishna KV. Reducing All-cause 30-day Hospital Readmissions for Patients Presenting with Acute Heart Failure Exacerbations: A Quality Improvement Initiative. Cureus. 2020 Mar 25.
  2. World Health Organization, Patient Engagement: Technical Series on Safer Primary Care.
  3. Jack BW, Chetty VK, Anthony D, Greenwald JL, Sanchez GM, Johnson AE, Forsythe SR, O'Donnell JK, Paasche-Orlow MK, Manasseh C, Martin S, Culpepper L. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009 Feb 3;150(3):178-87.