***This article originally appeared in Healthy Debate***
Hospitals sit at the heart of our healthcare system, acting as a vital access point for lifesaving and critical care. However, across Canada, an unfortunate feature of almost every hospital is a crowded emergency department (ED). With crowded EDs come long waits for the individuals and families wanting to access essential emergency services. The latest report from Health Quality Ontario suggests that individuals in Ontario are waiting on average 3.9 and 2.4 hours in EDs for more serious and less serious issues, respectively.
These wait times are the result of a number of systemic issues that our health system has been trying to address for years, but it fundamentally comes down to a restrictive and reactive care delivery model, which leads to a perpetual mismatch of supply and demand. Because of our continued dependence on physical infrastructure and in-person care, the dedicated individuals that work within our EDs are always fighting an uphill battle in terms of providing timely access to our citizens.
For example, if you show up to an ED today, regardless of how many patients are waiting with you or the severity of your condition, the ED’s ability to clear their queue and see you in a timely fashion will forever be limited by the number of physicians they physically have on-shift at that time. This has been the model for generations, but it doesn’t have to be.
In an ideal state, the staff in the ED will have access to virtual physician support so that those low-acuity — or less serious — cases can be swiftly handled virtually, via telemedicine, freeing up on-the-ground resources to handle those high-acuity cases that require more intensive attention.
Although this model is still far from the norm, there are examples of organizations globally who have taken that step, and the benefits are clear. New York-Presbyterian/Weill Cornell Medicine (NYP) implemented a virtual care diversion program for their ED and slashed low-acuity wait times from 2.5 hours — nearly identical to the current low-acuity wait times in Ontario — down to 30 minutes. With this program, NYP has also been able to keep ED revisit rates at about half the national average in the US.