The Emergency Department Express Care program at NewYork-Presbyterian/Weill Cornell Medicine has established one of the first telemedicine programs in its academic hospital emergency department.   The goal is to reduce the amount of time a patient with a non-urgent medical condition has to wait for care.  The hope is to provide more efficient care for these patients without compromising the quality of care received.  The New York hospital found that the number one complaint by patients is the length of time they had to wait before they were treated in the emergency department. The initial results are promising since wait time has dropped from an average of 2 to 2.5 hours to only 35 to 40 minutes.

All patients are triaged and screened by a nurse practitioner or physician assistant, and those deemed not to have life threatening injuries are given the option to go through Express Care.  This helps reduce the congestion in the emergency department. Those who choose this option are treated remotely by doctors in other areas of the hospital, which enable them to pivot back to their other responsibilities once they treat the patient. Express Care is available to patients 16 hours for each 24 hour period. A pilot project to expand the program in the pediatric emergency department began in April. To date the two locations have conducted more than 1,700 virtual visits.

The emergency department physician is connected to the patient through a videoconference, while the nurse practitioner or physician assistant is available to perform procedures, such as suture removal or ordering x-rays.  The doctor will order prescriptions as needed and send discharge papers to the patient through a printer located in the patient’s room.  The patient is billed for a standard emergency department visit since they have a full triage and screening by medical personnel. Most insurance companies cover these visits.

Some opponents to this new venture into telemedicine are worried that the quality of care will be compromised, for the sake of convenience. Proponents say the patient is receiving the resources needed to provide quality care, and that the nursing staff and physician assistants are there to assist the doctor with appropriate medical care.

The new program is receiving a lot of attention from other hospitals, and has recently had a visit from Ali Raja, vice chairman of the emergency department at Massachusetts General Hospital.  “Ten years from now, tele-emergency medicine will be the standard around the country,” Dr. Raja said in a recent Wall Street Journal report.

Source: Wall Street Journal, “Can Tech Speed Up the E.R.? by Sumathi Reddy, March 28, 2017

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