Because of the ease of access, more than 20% of ED visits are preventable, costing billions every year.
d2i’s data analysis tools can help develop an understanding of who visits the ED and why
Population health aims to manage and prevent illness across communities, while emergency care often responds to the gaps left by those strategies—like limited access to care and unaddressed social determinants.
Far from opposites, these two domains are deeply linked. Emergency departments offer critical insight into the failures and pressures within the broader healthcare system.
By analyzing ED data through a population health lens, healthcare organizations can uncover root causes, anticipate needs, and develop more targeted interventions. d2i’s analytics help connect these dots—turning reactive encounters into opportunities for prevention and better outcomes.
Table of Contents
Early Warning System
The Emergency Medical Treatment and Labor Act (EMTALA) mandates care regardless of a patient’s ability to pay, inadvertently transforming emergency departments into a primary care safety net for many Americans.
Unfortunately, this unintentional evolution of EDs has come at a significant cost. More than 20% of emergency department visits are preventable, costing $8.3 billion in 2019.
While this figure is substantial, it’s important to remember that optimizing care for high-acuity patients presents a far greater opportunity for cost reduction. This includes minimizing avoidable readmissions, ensuring smooth transitions of care, and providing adequate post-discharge follow-up. The number of low-acuity patients presenting to the ED may also be declining since 2019 due to the rapid expansion of urgent care centers.
Nonetheless, treat-and-release visits alone totaled $80 billion in 2021. Behind these costs are systemic population health challenges: uninsured individuals, delayed preventive care, and unmanaged chronic diseases.
During the acute part of the ongoing COVID-19 pandemic, ED visits preceded fatalities by about 2 weeks, providing early critical information about the outbreak within communities. By analyzing ED data, including utilization, hospitals and public health agencies can identify where the healthcare infrastructure is fraying and proactively address these issues before they spiral out of control.
Demographic and Social Determinants
Understanding who visits the ED and why is central to connecting emergency care data with population health. For example, the closure of a rural hospital leads to an increase in ED visits in the surrounding healthcare institutions, partly owing to a sudden lack of access to outpatient services in the community.
Examining the demographic and social characteristics of ED patients can also reveal systemic problems and barriers to care. In this context, data has demonstrated four key reasons behind ED visits that should have been primary care visits:
- Urgency of the condition
- Barriers to PCP access
- Advantages/ease of ED access
- The presumed quality of care in the ED
Population health ties directly into ease of ED access and barriers to primary care access. Uninsured patients, those living in poverty, or individuals in medically underserved areas are disproportionately represented in EDs.
These groups often face significant challenges, such as limited access to primary care, transportation issues, and food insecurity, which exacerbate their reliance on emergency services. By analyzing this data, healthcare organizations can identify at-risk populations and target interventions.
Consider a scenario where an ED observes high utilization rates among patients from a specific zip code. Further investigation might reveal that this area lacks adequate primary care providers or public transportation options. Armed with this information, health systems can advocate for community-level changes, such as opening a federally qualified health center or expanding telehealth services, to alleviate pressure on the ED and improve overall health outcomes.
Strengthening Preventative Care Through Data
Emergency department data can also offer invaluable insights into preventive medicine. By identifying the root causes behind ED utilization, healthcare organizations can shift their focus upstream, addressing issues before they escalate into emergencies.
ED data can be instrumental in combating the opioid epidemic. By tracking overdose trends, EDs can collaborate with public health agencies to implement naloxone distribution programs, harm reduction initiatives, and connect patients with rehabilitation services. d2i clients are actively responding to these urgent community needs by offering such services, all while diversifying their practices. One example is Emergency Care Specialists (ECS), which offers evidence-based addiction services through its subsidiary, Professional Treatment Solutions (PTS). PTS provides outpatient, inpatient, and ED-based addiction care and connects patients with recovery resources—meeting individuals where they are and supporting long-term recovery.
Ultimately, such efforts would align with the goals of value-based care — improving patient outcomes while reducing costs.
Enhancing Care Coordination
Beyond providing safety net access in the form of quasi-PCP, emergency departments are also a critical link in care transitions. By leveraging data, EDs can improve care coordination, ensuring that patients receive appropriate follow-up care while reducing readmissions and leakage to other health systems.
Data analytics can help shift the focus from episodic acute care to a patient-centered approach, addressing chronic conditions and improving care transitions. For example, patients with heart failure discharged from the ED are at high risk for readmission without timely follow-up, a key factor in CMS hospital quality ratings and reimbursement rates.
By using data analytics to identify these patients, EDs can work with primary care providers and specialists to ensure seamless transitions, schedule follow-up appointments, and provide resources such as home health monitoring.
Adopting a Holistic View of Community Health
Integrating population health and emergency care data enables healthcare organizations (HCOs) to take a holistic approach to community needs. Just as a canary in a coal mine serves as an early warning system for miners, the ED provides crucial early warnings about the health of a community. By analyzing ED data, HCOs can identify emerging public health threats, understand the impact of social determinants of health, and proactively address underlying issues before they lead to more serious consequences. This proactive approach helps ensure timely, appropriate care while reducing costs and improving overall population health outcomes.
Alan Eisman, d2i executive vice president, business development, elaborates on this point:
Understanding of the ED’s role as an indicator is becoming more widespread among our clients. By analyzing these valuable signals, we can identify opportunities for systemic improvements and develop more effective and equitable solutions.
For instance, d2i’s Emergency Medicine Performance Analytics consolidates disparate data sources into a single, actionable dashboard. d2i excels in uncovering historical patterns and providing context for data-driven decision-making. By examining trends in ED utilization alongside population health metrics, d2i can help providers and administrators alike identify areas for improvement and develop targeted interventions.
Such a holistic view would then extend beyond patient care to inform broader policy and operational decisions. For example, data from d2i’s platform can reveal geographic disparities in healthcare access, guiding resource allocation or advocacy efforts. It can also highlight systemic inefficiencies, such as overreliance on EDs for nonurgent care, prompting investments in telemedicine or urgent care.
A prime example of this approach is Emergency Care Specialists (ECS), a d2i client, which made the data-driven decision to launch the RightCare Clinic in Grand Rapids, Michigan. RightCare Clinic offers a patient-centered alternative to traditional emergency room visits, providing high-level care for a wider range of conditions than urgent care facilities, but at a significantly lower cost than hospital emergency departments.
Similarly, the Emergency Physicians Professional Association (EPPA), another client that makes decisions based on d2i data, now operates The Urgency Room across Minnesota. These clinics are staffed by experienced emergency medicine professionals and equipped with advanced diagnostic tools to handle various acute illnesses and injuries, aiming to deliver timely care and reduce unnecessary ED visits.
Building a Data-Driven Culture
The integration of emergency care and population health data is not a one-time endeavor but an ongoing process of continuous improvement. Healthcare organizations must foster a culture that embraces data-driven decision-making at every level, from frontline clinicians to administrative leaders. This requires robust data but also a commitment to transparency and collaboration to ensure trust in analytics.
For example, publishing metrics on ED wait times or readmission rates can motivate teams to identify bottlenecks and implement solutions, aimed towards reducing crowding, length of stay, patient LWBS (left without being seen), and boarding.
The collaborative use of data can also increase alignment between clinicians and administrators as they strive toward their goals, ensuring that quality improvement initiatives are both clinically relevant and operationally feasible. By working together, these stakeholders can address the root causes of population health challenges, optimize resource use, and enhance patient outcomes.
Connecting Data for a Healthier Future
Ultimately, bridging the gap between population health and ED data is not just a strategic imperative. In an era of escalating healthcare costs, growing disparities, and an uncertain regulatory future, leveraging the ED’s unique insights into community health can catalyze targeted investments that improve prevention in the short run and dramatically reduce cost over time.
For healthcare organizations, the first step is investing in analytics tools that empower stakeholders to uncover actionable insights from historical data. d2i provides the foundation for informed decision-making, enabling providers to address the full spectrum of patient needs while driving operational excellence. Contact d2i for more information on how our data solutions can help.