Drive around any medium or large U.S. city, and you’re likely to see a local health system advertising its emergency department (ED) wait times like convenience stores advertise gas prices. But the confidence to advertise one’s wait times often doesn’t track with the reality that patients face when presenting in the ED.
According to the latest data from the Centers for Medicare & Medicaid Services from the 50 states, Puerto Rico and the District of Columbia, 29 had ED wait times of 20 minutes or longer before being seen by a doctor. Total time spent in the ED exceeded two hours for 40 of the 52 areas. Long wait times aggravate patients and may cause some to leave without being seen or without receiving treatment, resulting in having an adverse impact on patient outcomes.
The question of whether wait times are increasing or decreasing is a matter of debate, depending on patient insurance status or geography. A 2018 study published in JAMA Internal Medicine reported that ED visits declined by 36 percent among commercially insured patients for low-acuity conditions during the 2008-2015 study period. Meanwhile, use of urgent care clinics surged 119 percent and retail clinics by 214 percent.
A recently released study from California, however, found that the number of ED visits rose 44 percent in the decade prior to 2016. Those admitted to an in-patient bed in the state spend, on average, an hour longer waiting than national figures show. The study author attributes the increase to older patients with complex medical conditions, high numbers of patients with mental illness and substance abuse problems and a lack of beds in hospitals, drug rehab and mental health facilities.
One potential solution to reduce pressure on EDs that also improves the patient experience, resulting in greater patient satisfaction, is the use of a health system-branded mobile app. The possible uses of such an app include:
- Providing ED wait times and a list of alternative providers
- Supplying a reputable symptom checker
- Gaining patient feedback on care
- Introducing resources for super-users
An app of this sort would not need to exchange protected health information (PHI), which would subject it to much more IT scrutiny, making implementation easier than you might imagine.
Providing ED wait times and list of alternative providers
Patients who can’t be seen immediately by their primary care physician or get sick/injured outside normal physician working hours naturally consider receiving care at the local emergency department. Even if the local ED has a zero wait, getting care for non-emergent conditions in the ED strains not only hospital resources but likely patient finances.
A branded hospital mobile app absolutely should advertise ED wait times, the better for patients to make informed decisions. But if the health system also operates urgent care or primary care clinics, those resources should be listed too. If the wait time for an urgent care clinic can be calculated, publish those times, along with their addresses, phone numbers and wayfinding options including a map with GPS directions and parking locations.
Mobile check-in would allow patients to keep their place in line while traveling to the clinic, helping keep revenue within the health system.
Supplying a reputable symptom checker
Along with finding the correct provider, patients also need to know whether their symptoms merit an ED visit or whether a clinic would be a better choice. In fact, some major insurers are refusing to pay health bills resulting from ED visits that are deemed unnecessary.
Nearly three-quarters of U.S. adults already check online for health and wellness information. And of those, more than one-third are looking at specific health conditions or symptoms. And since the estimated lifetime value of a new patient is about $600,000, it makes sense to keep patients within your health system whenever possible.
Many health systems use symptom checkers as not only an informational tool but also as a marketing tool. Imagine combining a symptom checker with the ED wait time and list of urgent care clinics within your health system. A one-stop resource for health information in your local market would be a powerful tool to keep patients loyal to your health system.
Gaining patient feedback on care
The emergency department experience is stressful for patients, their families and their caregivers. Adding cost-effective beacon technology can track app users’ waits in the ED, prompting feedback directly to staff after a certain period of waiting.
Keeping potential negative comments inside your health system rather than on social media serves two purposes: protecting your hospital’s reputation while letting patients know their feedback is valued.
You also can solicit feedback during or after the ED visit, even allowing them to take photos and submit comments. This is especially appealing to the younger Millennials and Generation Zers who have grown up sharing via technology and are seeking to use their mobile devices to engage with providers. A little proactive customer service can go a long way to improve patient perceptions of care.
Introducing resources for super-users
You’ve heard the statistic that 5 percent of patients comprise 50 percent of total healthcare spending. And these patients, who often are dealing with complex, poly chronic conditions, certainly wind up in your ED.
A better alternative to using the emergency department for primary care is to educate these super users about other care options. Ideas include a listing of physicians and clinics, tap-to-call transportation to a clinic and tap-to-call options to find an appropriate care setting or to connect with a care coordinator.
Finding your super users should be as easy as checking the EHR or asking a veteran ED staffer. Once the app is live, reach out to these patients to let them know about the app and how it can help them take better care of themselves.
A 2015 study shows that hospitals have only engaged with 2 percent of their patients through mobile apps, so the potential upside value of developing a branded app is extremely beneficial given the high consumer demand. Doing nothing shouldn’t be an option, because your hospital’s reputation is already being discussed in your community, on social media, on review websites and among area patients and residents.
What’s more attractive: controlling the narrative and making sure patients receive the information they want through a branded app or letting the conversation happen outside your purview?
Photo: simonkr, Getty Images