Forum Session

EMS "Hot Spotting": San Diego's Experience Creating a System of Care for Frequent Users of Emergency Medical Services
June 14, 2013


Jessamy Taylor, MPP


The San Diego emergency medical services program is a national leader in using real-time emergency medical services (EMS) data to identify "hot spots"—geographic areas characterized by heavy utilization and spending—and using that information to motivate stakeholders to create a more organized and efficient system of care for San Diego's most vulnerable people. Their collaborative efforts have resulted in documented cost savings through lower and more appropriate utilization. Although health care financing structures like fee-for-service reimbursement and the Medicaid Disproportionate Share Hospital (DSH) program do not currently discourage the cycling of individuals through the emergency department, forthcoming DSH cuts may change that. Creating a more coordinated system of care across EMS, inpatient and outpatient medical and behavioral health systems, and the social services and housing sectors presents a number of challenges and opportunities. This Forum session featured presentations from and discussion with the architect of San Diego's EMS hot-spotting work, the perspective of a federally qualified health center striving to provide a comprehensive health home for those identified as frequent EMS users, and 2-1-1- San Diego, a model information, referral, and assistance hub linking individuals with a broad array of health, housing, and social services.


James V. Dunford, MD, FACEP (bio)
Medical Director
City of San Diego Emergency Medical Services
Professor Emeritus
School of Medicine
University of California, San Diego

David Folsom, MD, MPH (bio)
Medical Director
St. Vincent de Paul Village Family Health Center
Associate Professor of Psychiatry and Family Medicine
University of California, San Diego

William York (bio)
Chief Operating Officer
2-1-1 San Diego

Related Materials

For additional information see the Forum's report of its site visit to San Diego.

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