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Healthcare's responsibility to the homeless addressed at HIMSS20

In California, providers are expected to manage a population without reimbursement outside of medical care, expert says.

Susan Morse, Managing Editor

Update: HIMSS20 has been canceled due to the coronavirus. Read more here.

For providers, homelessness is at the intersection of being a medical issue and a public-health concern, and it's starting to overwhelm local resources in some areas, including hospital emergency rooms.

New state laws in California demand hospital EDs take steps to more safely discharge homeless patients. This can be difficult when patients are reluctant to share their homeless status with ED staff. Also, few have the community infrastructure needed to comply with these laws.

The problem goes beyond California and its legislative mandates. The real issue is that healthcare is expected to manage a population without reimbursement outside of medical care, according to Dr. Ronn Berrol, emergency department medical director for Alta Bates Summit Medical Center in Oakland, California.

"I personally think we need to do what's right for the patient," Berrol said. "The legislation came out of people wanting to do something."

During HIMSS20, Berrol will explore how to use the resources available in the community to make a real impact on patients' lives. He will share the changes that Alta Bates Medical Center has made to provide ER physicians with insights at the point of care. It's an approach that reduces costs and contributes to better care outcomes for vulnerable patients.

Each state is different, and within each state counties can have different needs. What's needed is a quick and easy health-information exchange to identify area resources.

Berrol uses Collective Medical, in which real-time information through the ER shows up on a physician's track board. An estimated 80% of area hospitals use the same Collective Medical platform, Berrol said.

The product is able to identify the high utilizers of the ED, because it's been well established that "the top 1% users of healthcare chew up 20% of resources," he said.

Providers are able to link these high utilizers to a primary care provider to avoid the ER, the most expensive place to get care.

"I'm one part of this issue," Berrol said. "But healthcare alone can't solve the homeless crisis."

Dr. Ronn Berrol, medical director for Summit Emergency Department for Alta Bates Summit Medical Center, Oakland, California, will address "Navigating America's Hidden Healthcare Crisis: Homelessness," from 1-2 p.m., Wednesday, March 11, Room W330A in the Orange County Convention Center.

Twitter: @SusanJMorse
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