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Effect of a Virtual Patient Navigation Program on Behavioral Health Admissions in the Emergency Department: A
Jason Roberge1, Andrew McWilliams1, Jing Zhao1
1Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, North Carolina.
JAMA Network Open
|January 30, 2020
Summary
A virtual patient navigation program showed a trend toward reducing emergency department psychiatric hospitalizations. While not statistically significant, the intervention lowered follow-up self-harm diagnoses, suggesting potential benefits for behavioral health crisis care.
Area of Science:
- Psychiatry and Behavioral Health
- Health Services Research
- Digital Health Interventions
Background:
- Increasing psychiatric care demand in emergency departments (EDs) strains resources.
- Limited outpatient services often lead to conservative hospitalization recommendations.
- Need for effective interventions to manage behavioral health crises in the ED.
Purpose of the Study:
- To evaluate if a 45-day virtual patient navigation program reduces hospitalizations for patients with behavioral health needs in the ED.
- To assess the impact of virtual navigation on follow-up self-harm diagnoses and acute care use.
Main Methods:
- Randomized clinical trial involving 637 patients across 6 urban/suburban EDs.
- Intervention group received a virtual navigation program (video/telephonic outreach) for up to 45 days post-discharge.
- Control group received usual care; randomization occurred by day of the week.
Main Results:
- Hospitalization conversion rates showed a non-significant trend towards reduction in the intervention group (55.1%) versus usual care (63.1%).
- The intervention group had significantly fewer follow-up encounters with a self-harm diagnosis (36.8% vs 45.5%, P=.03).
- No significant difference in post-discharge acute care use was reported.
Conclusions:
- The virtual patient navigation program demonstrated a promising trend in reducing ED psychiatric hospitalizations.
- The significant reduction in follow-up self-harm diagnoses warrants further investigation.
- Investment in and research on virtual behavioral health programs are recommended.
