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According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), there were 129.8 million visits to emergency departments across America last year. Almost 38 million were injury-related and 13.3 percent of those seeking treatment were admitted. To put that into perspective, during that same reporting period, the total population of the U.S. was roughly 308 million, meaning that the equivalent of 41 percent of the population visited the emergency room. 

The drama inside emergency rooms as depicted on popular television shows doesn’t correlate to what really happens. While there are many life-threatening cases involving heart attacks and traumatic injuries or poisonings, there are also a lot of colds, flus, and insect bites. It’s no surprise that emergency departments have become a default source of care for populations without access to primary care, and that high rates of repeat patient visits to emergency departments and readmissions are straining the resources in our healthcare delivery system. Many of these patients are over 65 and suffer from multiple chronic conditions.

Emergency department physicians and their allied clinical staff must balance the competing demands of treatment and documentation. Documentation has long been a challenge for all physicians, and a recent study I discussed during a Sept. 30 ICD-10monitor webinar is a cautionary tale. This retrospective study of four million patients conducted by Humedica concluded that as many of 40 percent had significant comorbidities that were uncoded. These uncoded patients were chronic users of emergency department resources. Once these patients were appropriately identified and documented, their consumption of emergency department resources began to shift as they gravitated toward the more appropriate ambulatory setting, where, with proper focus and treatment, their chronic conditions such as hypertension and diabetes showed steady and sustained improvement. And this is in an ICD-9 world! 

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