Telemedicine Helps Reduce Overuse of Emergency Rooms—Could Urgent Care, Too?

A telemedicine ambulance triage system is helping to keep nonemergent cases out of the emergency room in Houston—perhaps indicating one more way urgent care could contribute to improving access to affordable, quality care for patients with non–life-threatening concerns. A briefing on Advisory Board notes that the city’s ED wait times were among the worst in the country 10 years ago, thanks to up to 50% of patients, in effect, seeking primary care in their local ED. However, a telemedicine system for ambulance-based triage has helped keep people who don’t need to be there out of the ED. In this particular program, firefighters specially trained in emergency medical services (EMS) are dispatched by 911 services. Once on site with the patient, they use tablet devices to consult with a nurse at a call center to determine whether or not transfer to the ED is truly warranted. Preliminary results of the program show that the share of people for whom EMS was dispatched who end up going to the ED fell from 74% to 67%. Patient satisfaction with the Houston EMS system is on the rise, too. The open question for urgent care is, how could local centers replicate these results cost effectively, collecting fees and probably earning new return patients in the process?