April 21, 2025

Evolution of the Observation Medicine: Science and Solutions Conference

Meredith Busman, MD

Since it began in 2012, the annual Observation Medicine: Science and Solutions Conference has adapted to fit the times. Originally hosted by the Michigan College of Emergency Physicians, this session has been held both in person and virtually and worked to educate physicians on current issues and ideas in Observation medicine, from reimbursement changes to leveraging an Observation Unit’s capabilities as part of a hospital’s pandemic response. Historically, both emergency and non-emergency physicians from as far away as Singapore have attended, attesting to the broad scope of the conference and growing interest in the field. In January the conference marked a new milestone when it joined with ACEP Accelerate in Orlando, Florida. This move brought the conference to the national stage for the first time since its inception, helping cement Observation Medicine’s place in the house of Emergency Medicine.

ACEP Accelerate is a novel approach to the traditional conference format, bringing multiple sessions together under one roof to support collaboration between interests and consolidate educational opportunities for the time-strapped emergency physician. Attendees enjoy the best features of a large conference while retaining the targeted education of focused meetings. Besides Observation Medicine, other courses offered at Accelerate included the Teaching Fellowship, ED Directors Academy, Reimbursement and Coding, and Pediatric EM Assembly. During the week, conference chairs commented on the overlap between certain sessions, such as Observation and the Directors Academy, and how some individuals may benefit from attending the sessions concurrently or in subsequent years.

While the greater assembly stretches over the course of a week, the Observation Medicine: Science and Solutions Conference is a 2-day event with built in opportunities for networking both with fellow attendees, and with participants of other sessions; future more direct collaborations between sessions have also been discussed. The event is designed to benefit both physicians looking to start an Observation Unit, and those with experience who are looking to expand or improve their service line. The entire Observation conference was live-streamed, giving learners the option to attend either in person or virtually. Presentation material was also available after the event, making sure people could access lessons learned and bring them back to their institutions.

Dr. Rebecca “Bex” Goodwin, MD delivered the keynote address on the state of research in Observation Medicine. She was most recently an Assistant Professor for the Department of Emergency Medicine at Virginia Commonwealth University (VCU) before moving to New Zealand to practice at a rural critical access hospital. Her recently published paper assessed existing research on observation units, examined diagnoses, clinical outcomes, finances, and health system comparisons to identify knowledge gaps related to patients in dedicated emergency observation units. This review aimed to spotlight future areas of research in observation medicine, and found that staffing models and discussion of non-chest pain diagnoses as two topics deserving greater attention. Observation-related literature was also discussed in subsequent sessions, including a presentation on the safe discharge of certain moderate chest pain patients without first obtaining a stress test.

Dr. Michael Granovsky, MD, FACEP, CPC and President of Logix Health has been a long-time supporter of the conference and returned for another year to provide attendees with important information regarding billing and reimbursement for observation patients. This sparked discussion about documentation, physician vs APP charts, and the benefits of creating a two-service observation model (where emergency and observation services can be billed for separately even when performed by the same physician pool).

As these examples of speakers and sessions show, the conference benefited from a mix of both experienced and first-time faculty who hailed from diverse geographical regions and care settings. Dr. Anthony Rosania, MD, FACEP and chair of the ACEP Observation Medicine section presented on advanced protocols for the treatment of substance use disorders and was part of a panel examining various social determinants of health and how they can be identified or addressed in the Observation Unit. Dr. David Meguerdichian, MD, FACEP spoke on how to create patient dashboards to capture metrics of success or identify problems and then using that information to champion an Observation unit to a C-suite or turn around a struggling unit. The conference concluded with a workshop where learners were encouraged to identify challenges to their observation service, brainstorm solutions using lessons learned during the conference, and collaborate with faculty on how to apply their proposed ideas. The topics and speakers mentioned already is regrettably incomplete, but the full schedule of speaker and events can be found on the ACEP Accelerate website.

The next Observation Medicine conference will be held in January 2026 during ACEP Accelerate in San Diego, California; registration will be available through the ACEP Accelerate portal. People interested in attending should sign up on the 2026 Interest List to be among the first to know when 2026 registration is open or new details are available. The conference is open to physicians, residents, advanced practice providers, and nursing leadership. Anyone with suggestions for topics they would like to hear discussed at future conferences is encouraged to email conference co-chair Dr. Meredith Busman.

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