By MICHAEL WHITNEY
Published Dec. 12, 2012

Study will look at cutting back on unnecessary emergency room visits
Snohomish County — Snohomish County wants to find better ways to help people who frequently rely on local emergency rooms for health care.
The county announced last week it’s conducting a new study to identify people who call 911 when they should be going to a doctor.
The study hopefully will help the county save money. The emergency room is the most expensive place to get health care.
A lot of people are going to the ER at the last minute because they’re not connected to a primary care doctor or clinic, officials said last week. Many of the county’s frequent ER users have mental health or drug and alcohol issues, county human services director Ken Stark said.
The study will examine fire department emergency medical services, hospitals, mental health and chemical-dependency databases to help identify these people. The study also aims to get these groups to communicate with each other to ensure people get the right care at the right time.
“First we have to figure out who they are,” Stark said, by mining health care databases to figure out what they need.  A full-time researcher at the county will be doing that work.
The next step is identifying why people are calling 911 and educating them or guiding them into primary care clinics and regular doctor visits.
Nothing this comprehensive has been done before, officials said. Officials don’t have a timeline for when the study will be complete.
The challenge is figuring out why people aren’t seeking continued care, Providence Regional Medical Center Everett interim CEO Preston Simmons said.
Providence tried to address the problem of people unnecessarily going to the ER by opening two clinics in the past decade. The hospital system estimates it diverted 14,000 people away from the ER and into its clinics for continual care, Simmons said.
Providence’s ER sees 95,000 visitors a year.
Helping these people get continued care through a doctor is “low hanging fruit” in combatting rising medical costs, Stark said. Reducing ambulance transports is one example.
The standard protocol is for ambulances to take people to the emergency room, where doctors usually provide referrals.
Not always, though: In one severe case that officials cite, a Snohomish County resident called 911 74 times and was taken to a hospital six times.
“If we don’t know about individuals falling through the cracks,” how can they be helped, Simmons said.
Providence implemented its own data sharing program that it’s building across five states to send medical information to doctors the moment people arrive at clinics or the emergency room, Simmons said.
The county is matching a $300,000 grant from The Amerigroup Foundation, a nonprofit arm of the Amerigroup insurance company, to do the study. Officials hope the results could serve as a pilot program for the rest of the state.
“By bringing all the parties to the table, we can do a better job in leveraging health care dollars that are tighter and tighter,” Amerigroup Foundation CEO Rosy Cozad said.
The foundation selected Snohomish County because it already has a working group trying to solve these problems, Cozad said. The group formed earlier this year and is unique as most counties don’t have anything similar, officials said.
Cozad said the study has spreading potential because it could be the backbone for other county programs throughout the state.
“Because Snohomish County is responsible for overseeing millions in grant funds for human services, we should help coordinate better options for people who don’t necessarily need a trip to the emergency room when they call 911,” Snohomish County Executive Aaron Reardon said. “With the funding from the Amerigroup Foundation, we’ll be able to continue the work we’ve already started.”