Faced with an average wait time of 296 minutes, The University of California San Diego Medical Center’s emergency medicine chair, David Guss, MD, knew something had to change. Especially when he considered demand for emergency department services will increase next year when millions of patients gain access to health insurance coverage under the Affordable Care Act (ACA).
Guss told HealthLeaders Media, he decided to conduct a pilot study that would test telemedicine in the emergency department. After two years of testing, he admits he doesn’t have the data to prove its effectiveness, yet. However he feels the preliminary results show emergency department telemedicine is as reliable as the traditional emergency care delivery system.
How it works
In some ways, the emergency medicine telehealth program at UCSD is similar to Fast Track Units at other organizations. Patients who are treated via telemedicine usually have routine problems such as a sore throat or urinary tract infection.
First, patients are screened by a triage nurse. If the nurse determines the patient’s condition is appropriate for the emergency department telehealth program, he or she is moved to one of six bays that includes a television screen with high resolution video equipment and high quality audio.
The physician appears on the television screen and uses extra equipment, such as an electronic stethoscope and a small camera to further examine the patient. A cool feature of the telehealh encounter is that when the small camera is used to view a patient’s ear or throat, the patient can see the images on the television screen, giving them a totally new experience.
As an extra precaution, all the patients who were treated under the emergency medicine telehealh pilot program were also screened by an onsite physician to ensure nothing was missed.
How it helps
Traditionally, when an emergency department experiences a surge of patients, they contact the on-call physician, who will come in for backup, but that isn’t an ideal arrangement. Depending on where the physician is located and what he or she is doing when the call is made, it could take an hour before help arrives.
Emergency department telemedicine could allow for more immediate assistance because the physician can log onto a computer and see patients from his or her current location.
How it’s going so far
Guss says he is optimistic that emergency department telehealth programs will decrease wait times and improve the hospital’s bottom line. Patients who were treated under the pilot program had an average wait time that was about half the hospital’s overall average.
He also says he has seen no evidence that telemedicine encounters are more prone to misdiagnosis and miscommunication.
