Overview

SmartControl™ is a care coordination solution that automates case manager workflows related to reducing visits by frequent users. This practice reduces unnecessary utilization of health care services, particularly hospital admissions.

Background

Frequent emergency department (ED) users are a mix of medically complex and psychologically fragile patients, alcohol and narcotic dependent individuals, and those that come for convenience.

Appropriateness of ED utilization can be gauged by the prevalence of those with more than three visits in a year, “frequent utilizers," and those who visit the ED more than 10 times in a year, “super utilizers." These groups respectively comprise 5% and 1% of patients and 25% and 5% of total annual visits in a typical ED.

Research demonstrates that non-reimbursed services can be significantly reduced by safely controlling the behavior of these cohorts. As well, contract positions with payers can be strengthened when a robust utilization control program is in place.

Methodology

SmartControl™ integrates with any EMR, identifies care plan candidates and organizes the patient’s designated care network (i.e., PCP, specialist, psychologist, social worker and/or family caregiver). Care plan templates are available for the most common medical conditions and social situation.

With the Smart-Control™ module in place, when an enrolled patient visits the ED automated notifications are sent to the patient’s care network so that each becomes aware of the visit and may share and may relay any necessary care plan modifications to the case manager.

Care plan patients can be contacted via email and text message (SMS) gateways and directed to a survey portal in their native language.  Using a computer, tablet or smart phone, each can complete a brief wellbeing check. As well, an embedded callback module is available to reach patient by telephone.

Built-in analytics measure acceleration or deceleration of visit frequency and thus identify care plan candidates and success stories. Savings related to decreasing unnecessary emergency department visits and hospital admissions are calculated to justify case management resources.

Published research proves that the SmartControl™  methodology cuts frequent visits in half, resulting in a substantial return on investment.

Functionality Diagram

Privacy, Security, Convenience

Smart-ER™ products comply with patient privacy and data security requirements defined by HIPAA and HITECH. Click here to view our HIPAA Privacy Policy.

Our cloud host has strict privacy controls, utilizes a vetted reporting mechanism, undergoes stringent audits, and is responsive to concerns. Client information is segregated on a single-tenant server and protected with multiple-layer passwords and strict authentication processes. Data integrity is assured by 256-bit SSL encryption and server authentication with extended validation certificates. The system is functional across multiple platforms including tablets and smart phones.

Clients have access to 24/7 technical support.