Why your next ER visit may be virtual


Laura Drucker

Essential Insights contributor, healthcare writer


Emergency departmentsor what’s commonly referred to as Emergency Rooms (ERs)in the United States see a lot of traffic. Every year, approximately 20 percent of Americans (or 130+ million people) visit an ER, even though they are not the optimal place for most types of care.

Overextended doctors and nurses and a host of non-urgent cases mean high demand, long wait times and long overall lengths of stay at ERs, resulting in a considerable amount of strain on the healthcare system as a whole.

The rapidly emerging practice of telehealth can help increase efficiencies in our healthcare system, particularly within ERs. New technologies are bringing patients face-to-face with physicians faster than ever before, allowing for the speedy transfer of images, videos, and treatment recommendations, as well as a reduction in wait times, lengths of stay, and costs.

As the technology expands so too does patient access, allowing those in historically underserved areas to connect with physicians and receive treatment quickly despite a lack of hospitals and healthcare workers in their area. The University of Pittsburgh Medical Center recently announced they were launching statewide access to emergency telemedicine services.

Here, we take a deeper look at how telehealth may be a game changer for emergency medicine.

Why your next ER visit may be virtual

Telehealth: A game changer for emergency medicine

The ER at a glance:

What emergency medicine looks like in America

Each year, 130.4 million people visit emergency rooms.

The average wait time before seeing a doctor is about 30 minutes.

The average overall length of stay is about 2 hours.

Who goes to the ER?

The most frequent reasons that people visit the ER are:

Most studies find that at least

30% of emergency room visits are non-urgent

The 4% of America's doctors who work in emergency medicine provide:

11% of all outpatient visits

28% of all acute care visits

1/2 of all acute care visits by Medicaid and CHIP beneficiaries

2/3 of all acute care visits by the uninsured

Due to lack of access to other providers, uninsured adults are twice as likely to visit the ER than those with private coverage.

Healthcare costs are rising,

but more efficient emergency rooms can help

2015 U.S. Healthcare Spending: 17.8% of GDP

U.S. healthcare spending reached $3.2 trillion in 2015, accounting for 17.8% of the GDP.

2025 U.S. Healthcare Spending: 19.9% of GDP

Overall healthcare spending is projected to increase at a rate of 5.6% a year. By 2025, it is expected to account for 19.9% of the GDP.

Emergency physicians play an important role in managing inpatient care costs. Of the 130.4 million ER visits annually, 12.2 million (9.4%) result in hospital admissions.

The average cost of a comprehensive emergency room visit is $922. The average cost of an inpatient stay is 10x higher at $9,200.

A key driver of increasing costs is inpatient care, accounting for 31% of America's healthcare expenses.

Between 13.7% and 27.1% of ER visits could be treated at other facilities like retail clinics or urgent care centers. The potential cost savings of treating these cases outside of the ER is $4.4 billion.

Telehealth can reduce overall costs

and keep people out of the hospital

The average estimated cost for a telehealth visit is just $40 to $50.

20% of ER visits require follow-up care for similar conditions, while only 6% of telehealth visits do.

A study of approximately 1,500 older adults found that telehealth was able to eliminate nearly 1 in 5 ER visits.

Regular use of telehealth services in nursing homes could save Medicare about $151,000 a year per facility in reduced inpatient admissions.

Early evidence of telehealth's success

The Veterans Health Administration saved nearly $1 billion in 2012 after implementing telehealth and other mobile health services. Annual savings per patient were $6,500.

After Mercy Health introduced their Virtual Care Center in 2015, expected inpatient lengths of stay decreased by 40%.

At Aurora Sinai Medical Center, the use of telehealth has reduced door-to-doctor times by 75%.

New York-Presbyterian Hospital and Weill Cornell Medical Center joined forces to create the NYP-Weill Cornell ED Telehealth Express Care Service in 2016. Within two months the service had reduced average ER visits from 4 hours to just 30 minutes for patients with minor complaints.

At Fuse by Cardinal Health, our innovation center, we work alongside customers to solve complex healthcare challenges and create solutions that transform the future of health and wellness. We are looking closely at how emerging technologies, including telehealth, can make care delivery more efficient in acute and other settings. Learn more at www.cardinalhealth.com/fuse.



http://www.rand.org/pubs/research_reports/RR280.html • https://projects.propublica.org/emergency/https://www.cdc.gov/nchs/data/nhsr/nhsr090.pdf • https://www.cdc.gov/nchs/fastats/emergency-department.htm • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4156292/#R9 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412873/ https://www.cms.gov/researchstatistics-data-and-systems/statistics- trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf • https://www.cms.gov/Research-Statistics-Data-and-Systems/ Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/proj2016.pdf •  http://www.connectwithcare.org/wp-content/uploads/2014/12/Medicare-Acute-Care-Telehealth-Feasibility.pdf • http://www.aha.org/content/16/16telehealthissuebrief.pdfhttp://www.healthcareitnews.com/news/nyp-weill-cornell-telehealth-program-slashes-ertimes-patients-minor-complaintshttp://www.healthcareinformatics. com/article/telemedicine/aurora-health-care-telehealth-use-improving-erpatient-flow • https://www.urmc.rochester.edu/research/blog/- june-2015/is-telemedicine-a-viable-alternative-to-ambulance.aspx