Helping Horizon Health Cut Hospital Use in Half

Published on May 3, 2018

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After the first week of gaining access to the Contexture portal, Dr. Fred Karst, Chief Operations Officer at Horizon Health and Wellness, knew that the Arizona health information exchange (HIE) was going to change the way they operate. In fact, Contexture has already helped them cut hospital admissions in half for its highest users. Serving a patient base of 12,000 with over 600 staff members, Horizon Health and Wellness offers mental health, behavioral health and primary care services in 10 Arizona locations. After participating two years in the HIE, Horizon has been able to incorporate the services that Contexture offers into its everyday workflow.

Dr. Karst recalled that he first discovered the value of the HIE when an elderly woman came into the facility and needed blood work. As the staff, including the chief nurse, faced a difficult time finding a vein for a blood draw, Dr. Karst remembered his newly granted access to the HIE portal. After a few simple clicks, he realized that the staff could put their needles away because hospital records from the previous day included blood work that was readily available in the HIE. As Dr. Karst recalled, this was just the beginning of Horizon Health and Wellness having success using the HIE. Beyond just using the portal, they now receive Alerts when high-needs patients are admitted, discharged or transferred from a hospital.

Dr. Karst admits that he “was shocked to learn how many of our patients were spending so much time in hospitals. We knew we had to do something about it,” he said.

To address the high hospital utilization, Horizon Health and Wellness identified 30 of its top utilizers – those frequenting the hospital an average of three times or more a month. Using Alerts from Contexture, they developed a successful three-part strategy to decrease visits.

First, they designated one person to receive and process all Alerts received from the HIE, forwarding patients’ information to specific care managers who could then follow up with the patient. Second, they developed an education pamphlet to better inform patients about the appropriate care to seek from the hospital ED versus other care alternatives. The pamphlet also contains information on the services that Horizon Health and Wellness provides for each of its various locations. Third, Horizon Health and Wellness focused on the needs of its seriously mentally ill (SMI) population, providing more weekend hours and encouraging them to come in without an appointment.

The results were extremely positive. Not only did Horizon Health and Wellness improve service and outcomes for its high-needs patients, but it was also able to reduce hospital emergency and inpatient visits. By receiving Alerts from Contexture on hospital admissions and discharges, the Horizon Health and Wellness strategy that focused on these top utilizers saw a reduction in the average number of visits to the hospital fall from 3.1 to 1.5 visits per month.

Dr. Karst says that he and his staff are now major supporters of Contexture. “I’m looking forward to watching Contexture grow” Dr. Karst said. “I’m excited for more medical providers to connect to the HIE so we can provide the best universal care for our patients.”

I'm looking forward to watching Contexture grow ... I'm excited for more medical providers to connect to the HIE so we can provide the best universal care for our patients.

- Dr. Fred Karst, Chief Operations Officer at Horizon Health and Wellness