Program Targets "Frequent Fliers"


A new Michigan clinic for a hospital system's ED "frequent fliers" is a chance for HM to help streamline care delivery, a hospitalist involved in the effort says.

Doug Apple, MD, hospitalist division chief for Spectrum Health in Grand Rapids, Mich., says the Spectrum Health Medical Group Center for Integrative Medicine will help deal with patients who have used the ED at least 10 times in the past year. In the past, many of the patients would be admitted to the hospital, becoming part of a hospitalist's census. Often, they will have nonspecific conditions, such as chronic abdominal pain.

"Patients get admitted, they might not see the same hospitalist, they may not see the same surgical specialist or GI specialist," Dr. Apple says. "And so every time they get admitted, there's a different plan, there's a different diagnosis or idea. … The intent is to figure out how are these individuals able to get better care, more appropriate care, in an environment that allows them to actually have somebody that pays strict attention to what their needs are?"

Dr. Apple, who worked on the conceptual planning of the clinic, says hospitalists will have no hands-on role with its initial operation, other than referrals. But he says hospitalists who proactively identify patients best cared for via the clinic could save themselves readmissions and ensure better transitions of care.

"We're trying to figure out how we make these transitions, either into a hospital, or out of a hospital, or between an ED and back to the clinic," he adds. "We're trying to make sure these transitions do not become gaps in healthcare."

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