How Virtual Consults Can Benefit the Emergency Department

By Lee Horner, CEO, Synzi.

Lee Horner
Lee Horner

In urgent care situations, being able to provide timely and quality healthcare is essential to the impact and satisfaction of the ED staff and related EMS team members. Using telehealth, current ED workflows can be enhanced to increase access and make collaboration between onsite providers and offsite colleagues and specialists easier and more timely. Virtual care platforms can rapidly improve the delivery of care, effectively addressing urgent patient needs while reconciling the gap in having available specialists on-hand / in-person for immediate consults. Virtual consults are a viable and valuable solution to helping improve outcomes in emergent care situations.

Providing Critical Care On-Demand in the ED

Seconds and minutes count in the ED. With a virtual care platform, a hospital’s ED staff can quickly access remote specialists and facilitate a virtual consult between offsite specialists and patients. Instead of losing crucial minutes, hours, or even critical days in the ED to call a specialist or wait for an in-person consult, ED staff can quickly reach the first available, designated specialist who can deliver a timely virtual consult and provide guidance as to diagnosis, admission, and/or transfer. With virtual care technology, specialists can provide the needed consult from anywhere and on any device. Key decisions as to whether the patient needs to be admitted, transferred or discharged can be made in minutes (vs. hours or days). The costs involved with keeping a patient in the ED are also contained, and the hours or days which a patient spends in the ED are reduced. As hospitals struggle to have multiple specialists on-hand at any time, virtual consult platforms can empower hospitals to leverage specialists within their networks to support their patient care objectives around-the-clock.

Reducing Waiting Time and Minimizing Leakage in the ED

Virtual care platforms are also being used to reduce waiting times in the ED and deliver routine care to patients with non-emergent conditions. In a recent study published in Telemedicine and e-Health, rural hospitals using telehealth reduced the time between patients entering the ED to receiving physician care, according to University of Iowa researchers.

Virtual care had decreased door-to-provider time by six minutes. The researchers also concluded that the length of stay in the ED of the initial hospital was shorter for patients who were eventually transferred but had initially participated in a virtual care consultation. At New York-Presbyterian/Weill Cornell Medicine, the Express Care program allows patients with minor injuries or non-life-threatening symptoms to be seen virtually by an offsite provider via video. When asked by the Wall Street Journal, “What’s the number one complaint of patients in the emergency room?” Rahul Sharma, the emergency physician-in-chief at Weill Cornell, responded: “Wait time.”

The hospital reported that the Express Care telehealth program has cut the average wait time in the hospital’s ED by more than half; between 35 to 40 minutes. As hospitals struggle to prevent leakage and minimize the chance of patients leaving their ED waiting room for another healthcare setting, virtual consults can help the waiting patients access the diagnoses and care they need in a more timely and convenient manner.

Expanding Impact into the Community

ED staff can also use virtual care platforms to expand their impact within their respective communities.  Rural hospitals face some of the biggest deficits in terms of having a range of specialists on staff. Providers in these hospitals can have access to a greater pool of specialists who can support urgent patient care via video when a particular specialist is not already on staff or readily available in-person.  Giving ED staff the ability to facilitate virtual consults on-demand improves their impact within their own community – regardless of distance between the ED and the specialist. ED staff can also conduct HIPAA-compliant virtual meetings to drive better collaboration amongst the broader care team across the care continuum. Communication can be maintained with the appropriate care team members (including the patient’s PCP, a pharmacist, a coordinator at the next care facility, etc.) to ensure the patient’s overall health needs are regularly discussed and addressed in the ED and during the transition of care – without requiring care team members to drive to/from meetings at different locations and facilities.

Preventing Unnecessary Transports to the ED

Virtual care is also extending its reach outside of the ED’s walls to the ambulance. Project ETHAN (Emergency TeleHealth and Navigation) is recognized for its impressive results in using virtual consults to reduce 80 percent of unnecessary emergency visits. By facilitating virtual consults with specialists, paramedics were able to prevent 6,000 unnecessary ED transports and reduce costs by $2,000 on average to treat a patient (from an average of $2,200 to $220). Virtual consults – instead of immediate transports to the ED – were effective at reducing unnecessary ED ambulance transports while increasing EMS unit productivity. According to the study, the median time from EMS notification to unit back in service was decreased by 44 minutes (39 vs. 83 minutes, median), equating to approximately 2.1 times greater utilization (dispatches per day) vs. the control group.

Enhancing Outcomes and Satisfaction for All Involved

Removing the geographic barrier between ED staff, EMS team members, and specialists helps patients get access to the care and expertise they need when they need it most. Being able to facilitate virtual consults will allow ED providers to help patients access timely, quality care – improving patient outcomes and provider satisfaction. Virtual consults will continue to increase as an impactful way of delivering timely, needed care.

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