Quick Home Visits for Geriatric Patients Reduce Unnecessary ER Visits

After reviewing Epic data from 400 ER visits for patients over the age of 65, Atrius Health found that nearly 50% of those visits did not require ER-level care. To improve patient care and curb some wasteful spending, Atrius created a program called Care in Place which sends nurses directly to the homes of geriatric patients who call in with concerning symptoms.

Now, instead of calling 911, patients can call their physician and have a triage nurse determine whether they need to go to the ER or if they could receive the medical care they need at home. If a home visit is sufficient, a visiting nurse arrives within two hours with no copay to the patient. Visiting nurses have direct phone access to other members of the care team at Atrius who can make treatment decisions and use Epic to order tests and prescriptions.

Within its first three months, the Care in Place program has seen 213 patients and prevented 93 unnecessary ER visits and an estimated 41 subsequent hospitalizations. The ability for visiting nurses and nurse practitioners to access the same patient chart has been critical to the program’s success, according to Senior Chief Innovation Engineer Eliza Shulman. “Being on the same medical record is so important,” says Shulman, “because you’re able to provide a much higher level of care when you know a lot about the patient.”

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