Overcrowding in emergency departments has long been a universal problem that ultimately compromises patient care quality and experience. Venturing into a seldom-studied niche, researchers explored the application of telemedicine in emergency rooms for care delivery; they found that implementing this practice led to reduced patients’ average lengths of stay and wait times while improving physicians’ efficiency and maintaining care quality and patient cost.
In recent years, rapidly climbing rates of ER usage, combined with increasing shortages of emergency care physicians, have lengthened the wait times and lengths of stay for ER patients. This results in crowded ERs, a lower standard of care delivery for ER visitors, impatient patients, and worn-out doctors who must travel between clinics.
To combat these challenges, a group of researchers led by Dr. Shujing Sun of The University of Texas at Dallas, explored the potential of adopting telemedicine in emergency rooms as a general solution that could lessen ER congestion ubiquitously. Published recently in the INFORMS journal Information Systems Research, the results of this metastudy clearly showed that using telemedicine to consult physicians—whether they were within the same building, at a different facility, or even at home—consistently led to shorter average wait time and length of stay.
The addition of telemedicine systems allowed physicians to increase their efficiency by eliminating the need to travel and smoothing the workflow. This led to lower wait times to see a physician, whether in-person or virtually; the doctor could be in the room, elsewhere in the building, or outside the hospital but still be accessible via telemedicine for immediate consultation with ER physicians. The availability of telemedicine in emergency rooms also enabled physicians at remote locations to supervise on-site nurse practitioners or physician assistants, removing the need to travel between clinics; without having to wait for a physician to arrive, on-site care providers were able to treat minor conditions more promptly. Furthermore, having improved access to physicians sped up the ordering of lab work. This, in turn, allowed the diagnosis and treatment to start sooner.
Sun suggested that in addition to efficient information exchange, telemedicine can be used to improve care delivery through flexible resource allocation. This would provide access to specialists that some hospitals might not have otherwise.
Unfortunately, as Sun noted, ERs have been slow to adopt telemedicine due to lack of evidence and inflexible reimbursement policies. To encourage adoption, she suggested improving reimbursement coverage and ending restrictions regarding cross-state practitioners’ licenses.
As increasing numbers of hospitals join the telemedicine network, Sun expects that the more even access to specialists will help offset imbalanced health care resources in rural regions and in other areas that lack specialty resources, thus easing health care access disparity. The widespread use of telemedicine during the continuing pandemic will provide Sun and other researchers with data to examine where, how, and why telemedicine programs affect various health care situations beyond the ER.
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