About the Program
Memorial Hermann hospitals collaborated with U.T. School of Public Health for a Houston hospitals' ER Use Study that revealed 40 percent of all treated and released visits are primary care related.
In 2008, Memorial Hermann Community Benefit Corporation launched the ER Navigation Program to address the problem of inappropriate ER use.
ER Navigation places a Community Health Worker (CHW) in Memorial Hermann ERs that are used heavily by uninsured/underinsured patients to identify more appropriate health facilities.
CHWs identify clinics that are the best fit for a patient's location, income, language, work hours and bus routes, and address issues that may lower the priority of health care (e.g., need for food stamps, rental support or assistance with utilities). They make appointments, arrange transportation, share information and referrals to community/safety net programs, and educate about public benefits and other payment resources.
While CHWs initially meet patients during an ER visit, much of their work is done in follow-up; ensuring a clinic appointment was made/ was successful and assisting with paperwork required for qualification for Medicaid, CHIP or county indigent programs.
The primary goal is to find an appropriate Health Home for patients and provide resources to navigate future concerns.
Patients in a six month pre/post navigation intervention timeframe experienced a 77% reduction in ER visits as compared to pre-ER activity after navigation assistance from community health workers.
Navigated patients returning to MH EDs decreased post-intervention, including patients with 5+ pre-intervention visits.
12 Months Pre-, Post-Intervention
|Number of Visits||Distinct Patients (N) Pre-*||Distinct Patients (N) Post-||% change|
|Total Patient (N)||23,853||8,432||64.7%|
*Day of intervention visit included in pre-intervention total.
Awards and Recognitions
One of five Memorial Hermann programs contributing to recognition as a finalist for the 2013 Foster G. McGaw Prize for Excellence in Community Service.
Publication in the Journal of Healthcare Management, Nov./Dec. 2013, Reducing Preventable Emergency Department Utilization and Costs by Using Community Health Workers as Patient Navigators, Kimberly R. Enard, UTHealth School of Public Health and Deborah M. Ganelin, Memorial Hermann.
The 1115 Medicaid Waiver DSRIP Program has allowed for expansion from three Memorial Hermann ERs to eight, with expanded shifts.
Over 13,000 unique patients without a PCP were connected to a Health Home in 2014/2015.