CS2-07 - Bringing Telemedicine to the Emergency Room: A New Way to See Patients
Monday, April 30
10:25 AM - 10:34 AM
Location: Innovation Zone, Booth 434
We have initiated a telemedicine program at New York-Presbyterian/ Weill Cornell that provides a dedicated physician to provide Emergency Department (ED) telemedicine services 16 hours a day, 7 days a week. While preforming a telemedicine shift, our physicians provide a number of distinct services including caring for direct to consumer patients, assisting in triage, and answering telemedicine calls from a local nursing home. In addition to consolidating these roles so that they are performed by one provider during a telehealth shift, we have also begun a program where this same doctor will provide care for low acuity patients who are physically in our two emergency departments; we call this novel service "Express Care."
Patients are eligible for an Express Care visit if they present to our ambulatory triage with low acuity Emergency Severity Index (ESI) scores. After receiving a medical screening by a Physician Assistant or Nurse Practitioner, patients are evaluated by the telehealth attending. The physicians who care for patients are all part of our medical school faculty who do regular ED work. The physician does a video exam and as needed can call in prescriptions, order ED medications or x-rays, and arrange for follow-up care. The Express Care physician reviews discharge and follow-up recommendations and discharges the patient, providing them with discharge instructions directly to the patient's room.
Since Express Care was launched in July 2016, we have seen more than 5,000 patients with a typical length of stay of 35 to 40 minutes - as compared to the average stay of 2 to 2.5 hours. The implementation of this program has allowed us to streamline care by reducing workflow interruptions and delays, and allows providers and staff in the main ED to focus their attention on patients with more emergent medical conditions. Patient satisfaction scores have been outstanding, ranking in the 99th percentile. Our physicians have also indicated that they enjoy providing this virtual care. As part of our ongoing quality assurance program, we monitor 72-hour ED revisit rates for our ECS patients. Currently, the number of ECS patients who revisit the ED within 72 hours of their virtual visit is less than 3%, which is lower than the 3.5% to 7.5% that has been reported for ED patients in traditional settings.
- Describe how Telemedicine Emergency Department Physician can treat patients who are physically in the Emergency Department.
- Define the departmental and patient level advantages of using a dedicated Telemedicine physician to care for low acuity emergency department patients.
- Understand the role of Express Care Service in streamlining Emergency Department efficiency for low acuity patients.