Should ED Wait Time Billboards Go Blank?

Forget about touting short emergency department wait times. Reducing volumes of non-emergent patients in the ED is a higher-value pursuit.

The hospital marketing tactic of promoting short emergency department wait times is out of step with the swift changes in the healthcare industry.

Through billboards, websites, and mobile apps, hospitals have been promoting their speedy ED wait times to patients. In fact, new tools to help them do so are already making headway in the new year.

The nonprofit journalism site ProPublica launched its ER Wait Watcher tool in late December. The site calculates average emergency room wait times based on the most recent federal data compiled by the Centers for Medicare and Medicaid Services. It also uses Google mapping to calculate the time it will take to arrive at the hospital from your current location, even considering current traffic.

Another popular app, iTriage, allows patients to check ER wait times on their mobile devices. It also allows users to set up prompts that will check in with an emergency room and send notification that they are on their way.

Hospitals have been using technologies like these in order to attract new patients as well as improve the patient experience by decreasing wait times in their emergency room, but, since more and more patients are using the emergency room for non-urgent care, it's becoming clear that this tactic is treating the symptom, rather than attack the systemic problem of directing patients to the proper access point.

Though a goal of healthcare reform was to shift people out of ERs and into family practices for preventive care, the expansion of health insurance coverage for the poor under the Patient Protection and Affordable Care Act has resulted in a significant increase in costly emergency room visits, according to a study recently published in the journal Science. The 18-month-long study, which traced 25,000 low-income Oregonians who won Medicaid coverage in a lottery, found a 40% increase of emergency room visits among the newly insured.

The study's researchers found that the correlation between expanded health coverage and increased ED visits was so strong that it held true "across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings."

While the solution here may seem simple—to educate the newly insured about their best point-of-care options depending on their condition—there's more at play. ER marketing is good for business; common emergency procedures, such as CT scans and MRIs, are very profitable for hospitals.

But this practice drives up overall medical costs. The ED is a very expensive place to provide non-emergency care.

Tenet Healthcare, a for-profit health system with hospitals in 14 states, is expecting an influx of newly insured patients and is taking steps to make care more affordable by cutting costs in urgent-care centers and freestanding EDs, CEO Trevor Fetter told CNBC.

"It's a very hard thing to educate the patients that they ought to go to a physician or try to make an appointment if they're experiencing emergency conditions," Fetter said. "They're going to go to an urgent care, an emergency department, or a hospital. Our job is to be ready for them and to provide the service at a more affordable cost. I think that's part of the challenge for the future."

While it's true that educating newly insured patients about the proper access point will be difficult, hospital marketers must help answer the challenge. Rather than highlighting ED wait times, can marketing tactics help keep non-emergent patients out of the ED?