Problem & Purpose: An urban ambulatory care clinic for people with substance use disorder must balance a low-barrier methadone access model with addressing high need, high use preventable emergency department and hospital admissions visits (ED/HV) reported on disparate healthcare system electronic platforms. A two-year retrospective review found 23% of patients were high ED users (4+ visits/year). The objectives of this quality improvement project were to: a) develop and implement a comprehensive ED/HV tracking system from multiple electronic platforms b) design and implement a remote triage protocol to identify patients requiring in- person nurse assessment efficiently and c) evaluate the effectiveness of integrated tracking and triage systems to improve care coordination. Methods: A systematic remote triage system was established flagging ED/HV discharged patients requiring in-person nurse triage. A HIPAA- protected spreadsheet facilitated tracking of all ED/HV discharges, remote nurse triage interventions, and interdisciplinary team meeting referrals. The methadone program’s care management designated “Health Home” nurses monitored health information exchange notifications and medical nurses monitored Microsoft® TEAMS Incoming Calls & Patient Dosing threads. Results: A total of 243 ED/H visits by 89 patients were identified, with 42% of visits remotely triaged, resulting in 54 in-person triage visits and 21 patients referred for interdisciplinary team discussion. The process provoked the creation of user-friendly templates for in-person nurse triage and incoming (dose verification) calls. Additionally, methadone patients not formally assigned to medical services at the project site were prioritized for engagement in care. Conclusions: Ambulatory sites can potentially enhance care and healthcare system cost savings by remote triage monitoring of ED/HV discharged patients. Remote triage mechanisms can integrate information from disparate electronic platforms facilitating increased rates of transition of care and interdisciplinary care services. Analyzing workflow can have desirable secondary impacts, such as creating easy-to-use electronic templates on EPIC® and Microsoft® TEAMS while also identifying new mechanism to ensure that transition of care is completed for patients with extreme high need, high acute care use.