Tuesday, November 26, 2013

How I Was Able To "MakeTheRightCall"

As a staff member working on the “MakeTheRightCall” campaign, I know about the importance of connecting with a primary care physician for non-emergency needs.  A few days ago, an opportunity arose where I learned this firsthand.

My son Xander had been battling a cold and running a low-grade fever for about two weeks.  After a few days with the cold, I gave him over-the-counter medications, which brought his temperature down.  Xander then seemed to feel better and went along with his normal routine.  However, the cold returned with a vengeance and my babysitter texted me around 4:15 on Thursday and said that Xander had spiked a high temperature and she needed me to come and take him home immediately.

As I drove to the babysitter’s house, I called Xander’s primary care physician, a pediatrician, for advice.  She has been his doctor since he was just a few days old so I knew she would help me make the right decision about what to do.  I was pleasantly surprised to learn that the office had Thursday evening appointments and they could get him in at 7:10 that night. I made the appointment right then and felt relieved that she could see him so quickly.

After a short evaluation, the doctor diagnosed Xander with a sinus infection and prescribed an antibiotic, which she immediately called into my pharmacy.
 
Xander with his pediatrician, Nancy DeBlasis, MD
and Gayla Winzinger, LPN
I am happy to report that Xander, who my husband and I lovingly refer to as Captain Chaos, is now feeling better and is back to his normal self again.  When I think about making the right call, I am very happy with the decision that I made to call Xander’s pediatrician first.  I have a high deductible health plan, so going to the doctor’s office for Xander’s medical needs costs much less than going to an emergency department.  Also, I felt reassured knowing that his doctor already knew him well and had all of his health records on hand for making decisions during our visit. Further, I also felt more at peace knowing that we were able to quickly and efficiently get Xander’s medical needs addressed. 


I know it is hard to know what to do when faced with medical needs, especially with a sick and irritable child, but having a relationship with a pediatrician or primary care physician can help you “MakeTheRightCall”.  It certainly helped me.

Lori McAleer,Project Manager, Health Transformation
Greater Cincinnati Health Council






Monday, November 11, 2013

The Right Care, The Right Place, The Right Time

When you need medical attention, don’t you want to get the right care, at the right place and the right time?  Of course you do.  Since 70% of Emergency Department (ED) visits are not emergencies or could have been prevented with timely and effective care in a doctor’s office, most of us aren't getting the right care, at the right place and the right time.  Don’t you find this disturbing?

Why Should We Care?

  • There's a big cost difference.  An average ED visit costs $1,316 and an average doctor office visit costs, $145. (Note: The amount you or your insurance company pays could be significantly different.)
  • Out-of-pocket insurance costs for an ED visit are higher with a co-pay ranging from $50-$150+ and possible co-insurance of an additional 10-50%.
  • Unnecessary visits to the ED can have a negative impact on the quality of ED care due to crowding, long waits and added stress on staff.  These can take away from patients in need of true emergency care.
  • Your quality of care is affected.  The ED isn't the best place to get care that your primary care physician can provide.  Because the ED may not have access to your medical information, you may face redundant medical tests and have an increased risk of medical mistakes.
Why are we going to the ED when it’s not a life threatening situation or a real emergency?

An analysis by Truven Health MarketScan shows these common diagnoses for non-emergency department visits are:
  • Skin rashes
  • Head and neck symptoms
  • Sore throat
  • Back disorders
  • GI symptoms
  • Urinary tract infections
  • Ear aches
  • Bronchitis 
  • Sprains of ankle and foot
  • Asthma
Here are some steps you can take to help you MakeTheRightCall:
  1. If you don't have a primary care physician, visit YourHealthMatters.org to find one in Greater Cincinnati that meets your needs.
  2. Strengthen your relationship with you primary care physician by making sure he or she knows your medical history and if you have a condition such as diabetes or asthma. Talk to your doctor about when you should go to the Emergency Department. 
  3. Learn or ask about your primary care physician’s after-hours procedures (most have a doctor on call). 
  4. Learn the symptoms of a stroke, heart attack, or other life-threatening conditions that might come on quickly and require immediate medical attention. 
  5. Everyone feel aches and pains, but if you have pain that is not typical and/or worries you, call you doctors and discuss it right away. And if you are suffering a true medical emergency, call 911 or seek treatment at the Emergency Department.

To learn more about getting the right care at the right place and the right time, join the MakeTheRightCall campaign on Facebook.

Judy Hirsh
Director, Consumer Engagement & Programs
The Health Collaborative





Monday, September 23, 2013

Know “When To Make the Right Call”: A Doctor’s Perspective

When you need medical attention, what do you do? Where should you get help?  Should I go to the Emergency Department or can my primary care doctor handle this problem?  As an internal medicine doctor, I often come across patients who are struggling with these same questions. 
   
A new community campaign called “MakeTheRightCall” can help you answer these questions.  “MakeTheRightCall” campaign helps to educate you on how to get the best quality and lowest cost care when you have a primary care physician that knows you.  It also helps you learn when you may need to go to the Emergency Department or when your primary care physician can take care of your medical need.  By contacting your doctor, they can help ensure you get the right care, at the right time, from the right place. 

Although the Emergency Department is open 24/7, it’s a place to take care of life-threatening emergencies. 

Here are some of the reasons why someone should go to the Emergency Department:

  • Loss of consciousness.
  • Pressure, fullness, squeezing, burning or pain in the center of the chest
  • Sudden weakness or numbness of the face, arm or leg on one side of the body; sudden loss of vision or speech
  • Severe shortness of breath.
  • Bleeding that does not stop after 10 minutes of direct pressure.
  • Sudden, severe pain.
  • A major injury, such as a head trauma.
  • Coughing up or vomiting blood.
  • Severe or persistent vomiting.
  • Suicidal or homicidal feelings.

When you choose to “MakeTheRightCall”, it not only helps you but also helps others.  When other people misuse the Emergency Department, it drives up overall health care costs.  It also prevents Emergency Departments from tending to true medical emergencies as quickly as they can. Non-emergencies make the wait time longer for all patients in the Emergency Department.    It also costs you and your family more and takes longer than if you went to your primary care physician.  Your primary care physician will know you better than anyone in the Emergency Department too, so you won’t have to provide a lot of information about your medical history.  Isn’t that nice to hear?

The Health Collaborative, a local non-profit organization, felt that improper use of the Emergency Department was so important that it created a whole campaign around this.  To learn more, you can check out the two “MakeTheRightCall” videos MakeTheRightCall: When you need medical attention who do you call?  and MakeTheRightCall: Know the Difference.

I know that it can sometimes be difficult to decide where to go when you need medical care.  Thankfully, there are resources that can help you “MakeTheRightCall”.  Please be sure to use the Emergency Department for life-threatening emergencies.  If you are looking for a primary care physician, you can find one at http://yourhealthmatters.org/.

Stay well,

Dr. Shivani Jindal, MPH, MD
Chief Resident of Quality and Safety
Veteran’s Affairs Medical Center


Thursday, September 5, 2013

The Impact of the "MakeTheRightCall" Initiative

Sometimes the initiatives we are working on at the Health Collaborative hit close to home.  Earlier this summer I was enjoying a Saturday evening at a park with some friends when I took a misstep off a curb. That led to an embarrassing, slow motion tumble followed by an intense pain in my right ankle.  After I dusted off my pride, I realized the bruising and swelling was almost instant.  Not fun or pretty.

My friends offered to take me to the emergency room but as I thought about it, I realized this wasn't an emergency. There was nothing even potentially life threatening about my ankle turning shades of blue. I could hobble around so I was confident nothing was broken and in danger of being made worse.  The biggest issue was pain, and I could ice, elevate, and take Naproxen to get through the night.  I decided to spend the evening being as comfortable as possible at home and let the Emergency Department staff worry about the real emergencies.  I knew that in the morning, if I felt I needed treatment, I could call my primary care doctor and find out what he recommended.  

I felt pretty smart.  Not only was my Saturday evening at home much more peaceful than it would have been in the emergency room, but I’m sure I saved myself hundreds of dollars I would have billed just to be seen by an emergency physician.  My ankle is healing slowly but surely and I know I made the right call.

Laura Randall

In addition to being a clumsy walker, Laura Randall is the Director of Communications at the Health Collaborative.




Wednesday, August 21, 2013

Making The Right Call

The "MakeTheRightCall" campaign is helping to educate individuals to choose whether to visit the emergency department or a primary care physician when faced with a medical problem.  Here is a story from one local woman who made the right call by deciding to go to the Emergency Department when faced with a medical issue.

My ER Experience

 My name is Jan Mikina. I turned 60 at the end of last year, and am fit, slim, active, and healthy, being fortunate to have had no major health concerns over the years.

In late April, I had just finished doing a light workout about 1 a.m., and suddenly, I felt as though a huge vice grip had attacked my head. From my forehead to the base of my skull, I felt extreme, mounting pressure. My vision was affected as well – everything seemed brighter, almost as if all objects had an aura surrounding them. I knew something was terribly wrong.

I was alone in the basement family room, but I knew my husband was upstairs sleeping. Somehow I was able to walk up the stairs, through the kitchen, and down the hall to the bedroom. I seemed to be walking through a light tunnel, and the vice grip on my head just kept tightening and tightening. I woke my husband up and told him something was very wrong, that I needed help. Within minutes, our adult son was helping as well. I became nauseous, started seeing double, and the vice grip of pain never let up. I remember saying I needed to go to ER, and that we’d better bring a bucket…I knew I was going to be sick. There was no doubt in any of our minds that I needed help, and fast.

I recall very little of the 15-20 minute drive to the ER. My husband kept me talking and alert, and before I knew it, I was walking into ER, bent over and holding my head. Intake nurses asked my symptoms, and I was still conscious enough to be able to explain what I was feeling. They seemed to know immediately that I was experiencing a ruptured aneurysm in my brain. I became nauseous again and experienced more double vision and bright auras. I met several doctors, signed papers, and was told that I would need to have emergency surgery, that blood was leaking from the burst aneurysm into the area surrounding my brain. The doctors told me that the fact that I was still talking and understanding things, and that I could sign the consent forms, all boded extremely well for my recovery.

And then I remember nothing until awaking in the recovery room I don’t-know-how-many hours later. My neurosurgeon was by my side. He seemed to be glowing, almost celestial. My vision was still very strange, and there was still pressure at the back of my skull, but the excruciating pain was gone. He told me that I was very fortunate to still be here, to not be paralyzed, and that by everything he could see, I was going to be just fine…that my husband and I had acted quickly, and done the right thing in heading to ER immediately. He explained that the aneurysm was caused by a congenital weakness in the artery. Ten days later, including a week in the Neuro-ICU, I was home recovering, with all my senses and faculties just as they had always been. I did not need any rehab or therapy at all, and had lost none of my abilities. All I needed now was a lot of sleep! I consider myself beyond fortunate. My neurosurgeon and his staff saved my life.


In addition, the scan that was done when I arrived at the ER showed not only the one ruptured aneurysm, but another intact aneurysm on the opposite side of my head. I am scheduled to undergo a second operation at the end of August, to clamp the intact aneurysm so that it will not rupture in the future. While I hate to have to undergo major surgery a second time, I am so fortunate that this problem was discovered by the ER staff.  Soon I will be able to put this experience behind me.


A bit of important back-story – I had experienced a similar “attack” one evening three weeks before the rupture, but much less severe. With my decades-long history of battling sinus headaches, I assumed it was the mother-of-all-sinus-headaches. This time, too, the vice grip pressure had come on suddenly, both in the front and back of my head, and I experienced some brightness in my vision, but – though painful – this discomfort felt very much like nothing more than a horrible sinus attack. I did not consider going to the ER, and just treated myself at home with OTC pain meds, hot compresses, and sinus washes, and felt better within hours, though the “sinusy” feeling continued to bother me for days afterwards, along with other odd symptoms (stiffness at base of skull, rushing sounds in my ears). All these were consistent with severe sinus congestion, so I just ‘self-diagnosed’ and hung in there. However, I was told in ER, when my husband mentioned that I’d had a similar but much milder headache a few weeks earlier that this was a forewarning – it was the aneurysm leaking a bit in advance of the eventual rupture. In hindsight, I could have saved myself from a full-blown rupture and the possibility of death or paralysis, by seeking medical help after the first “attack”. 

Thursday, July 18, 2013

We Only Make the Right Call 50% of the Time

We've all heard that hospital emergency departments are over-used and not appropriately used.  Dr. Jane Brody of the New York Times shared some surprising facts:

Tuesday, June 18, 2013

Why You Need a Primary Care Physician (PCP)

Really?  Why do I need a primary care doctor?  I don’t get sick. 

Is this your attitude?  It is for many people.  

Here’s a couple reasons why you should get a doctor if you don’t already have one:

  • A big one is prevention.  You and your primary care doctor will review your family history to make sure you receive the right screenings like cholesterol, blood pressure and cancer prevention. 


  • Be prepared.  Most everyone gets sick and you need to have a relationship with a primary care doctor before you need one.  This is important in emergency situations or to avoid the expense and hassle of going to the emergency department when seeing your own doctor would be the right call.


Need to find a primary care physician in Greater Cincinnati? Start looking on www.yourhealthmatters.org  where you can view quality of care ratings for local doctors.

Thursday, June 13, 2013

Do YOU, MakeTheRightCall?


Have you ever wondered if you were making the best decision for you or your loved ones about when it’s time to visit the emergency department versus the family doctor? Of course you have; we all could use some help in this area!  It is for that reason that . . .
YourHealthMatters has launched a community-wide effort to help you MakeTheRightCall when you need medical attention. You'll get the best quality and cost efficient care when you have a family doctor who knows you and we will show you why.  We want to help you be prepared to know when it’s appropriate to call your family doctor and when it’s appropriate to go to the emergency department. And if you don’t have a family doctor, we will even show you how to find one that is the best fit for you.

To get this conversation started, we need to hear from YOU. What have been your experiences with making choices about going to your family doctor versus going to the emergency department? When you’ve chosen the emergency department, was it the right call?  We invite you to get involved by checking out this video YourHealthMatters: Street Interviews to hear what others in Greater Cincinnati have said.
 
Like us on Facebook and follow the conversation on Twitter. And jump in to let us know what you think.

 
If you’re wondering why this is important, you should know that misuse of emergency department resources drives up overall health costs across Greater Cincinnati. It also prevents emergency departments from tending to true medical emergencies as quickly as they can. Finally, it costs you and your family more in time, money and exposure to other illnesses to visit the emergency departments for things that are actually non-emergencies. Still, it’s a tough call to make if you are unaware of the types of ailments that can be treated conveniently and affordably by a family doctor. That’s where we step in.
 
We are working with members of United Food and Commercial Workers Union (UFCW) Local 75, the Council on Aging of Southwestern Ohio, Universal Health Care Action Network of Ohio (UHCAN) and the Health Collaborative Consumer Council to help you and your family get answers to these big questions.
 
Join them, join us to MakeTheRightCall.  Be prepared for times when you need medical attention in the future. Make The Right Call so you get the right care from the right place at the right time. We’re excited for this journey and we can’t wait to do this with you.
Stay Healthy,                                                                                                                             
Judy Hirsh
Director, Consumer Engagement & Programs
The Health Collaborative