Reducing Emergency Room Usage
Franklin Memorial Hospital
Like a lot of hospitals in Maine and across the country, Franklin Memorial Hospital in Farmington was seeing
patients in its emergency department who didn’t need to be there.
The problem wasn’t patients coming in with something potentially serious—like chest pain—that turned out to
be something minor—like heartburn. Instead it was patients, with ailments like strep throat, who would have
been better served seeing their primary care doctors.
“It’s better for patients,” to be seen by their own doctor, said Mavis Dubord, RN, practice administrator for
Franklin Community Health Network, the hospital’s parent organization.
For one thing, it’s less costly, she said. The average reimbursement for an emergency department (ED) visit
at Franklin Memorial Hospital is $538. The average reimbursement for an office visit is $98. Redirecting the
non-emergencies to primary care offices also frees up emergency room personnel for actual emergencies.
And, patients who seek care from their primary care providers, see providers who know them well.
“The primary care office knows the whole picture,” Dubord said.
The health system’s effort to reduce emergency room usage has two main components. The first was to make
primary care more accessible so people wouldn’t use the ED for non-emergencies. The second was to improve
the way the hospital sent patients home so they didn’t return to the ED with avoidable problems.
About three-and-half years ago, the health network started focusing on establishing a patient-centered medical
home model of care in its primary care practices. Medical homes are teams of practitioners who work together
in a coordinated way to give patients the best and most appropriate care. However, that model doesn't work if
patients bypass their medical homes in favor of the emergency room for non-emergency care.
Some of the problem had to do with the way the network’s primary care practices were operating.
"The primary care office knows the whole picture."
Franklin Memorial Hospital
