Rajlakshmi Krishnamurthy, MD, is the associate dean of population health at Yale School of Medicine and the chief population health officer for the Yale New Haven Health System. This is a lightly edited excerpt from her interview on the Health & Veritas podcast, episode 191, “Coordinated Care, Better Care.” Listen to the whole interview for more information on Krishnamurthy’s work building holistic systems for care.
Q+A
Quick Question: How Can We Connect Emergency Room Patients to Primary Care?
Many people rely on emergency rooms for regular medical care. How can hospitals better support this population?
Rajlakshmi Krishnamurthy, MD: One way is we can start with our patients who are already connected to primary care services within our community or with existing federally qualified health centers. How do we coordinate with those services and centers and how do we message to patients? And one particular initiative has been improving how we triage. So, when our patients call us, how do we in a timely, organized, evidence-based way triage patients and bring them to the right site of care?
The other way that we can work in terms of partnerships is to think about community health workers to connect patients to primary care and more of a longitudinal system of care. Oftentimes, our patients come to the emergency room (ER) because they have no other options. But we do have options across the city, across our state. How do we make those connections and how do we support our patients in getting care at a more cost-effective and more comprehensive site of care potentially for them than using the ER?
Right now, we're looking at patients who have multiple visits to the hospital and to the ER. And we’ve created a program where one of our community health workers in Bridgeport or New Haven meets those specific patients in the hospital and asks, "What can we do to help you with your care?"
And then we dig deeply into what are the social needs, what are the social drivers? Is it that you're not able to get transportation? And we look. Just a particular example, sometimes it's affordability or coverage of a specific drug. And we have worked with specific pharmaceutical companies on indigent programs that they sometimes have to help get drugs covered. And we've seen some outcome differences where the patients have not had to come back to the hospital because we've connected them to a federally qualified health center and connected them to that medication.
And just by doing some of the leg work, we can help avoid a hospitalization or an ER visit or several and get them connected into the right care.
Health & Veritas is hosted by Yale School of Medicine’s Howard Forman, MD, MBA, professor of radiology and biomedical imaging, and Harlan Krumholz, MD, SM, Harold H. Hines Jr. Professor of Medicine (Cardiology).
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