4 Ways to Accelerate ED Triage, Boost Revenue

Success Key No. 4: Videos for emergencies

Pediatric emergency and critical care physicians at UC Davis Children's Hospital use videoconferencing with patients and physicians and 10 EDs in rural and underserved areas of Northern California. The program has been found to improve diagnostic and treatment processes, while likely resulting in cost savings, better quality of patient care, and increased family satisfaction, says James Marcin, MD, director of pediatric telemedicine for the Center for Health and Technology at the 110-staffed-bed UC Davis Children's Hospital.

The enhanced video technology allows UC Davis to offer expertise to rural healthcare facilities that typically have less access to pediatric subspecialties. Rural EDs may lack the resources to adequately assess and optimally treat acutely ill and injured children, Marcin says.

Using high-speed data linked to video units at the UC Davis Medical Center, outlying California hospitals and clinics, physicians, and patients can have a live interactive connection with a UC Davis specialist by simply dialing the specialist and seeing him or her on video.

The program also provides these remote EDs with standardized triage protocol, laminated reference cards, and periodic pediatric critical care training in an effort to increase physician knowledge and improve consistency and quality of care.

Marcin says the program is especially important for rural areas with geographical barriers, such as those in or near the northern Sierra Mountains. Specialists can't simply fly into certain areas quickly to provide care, but they are able to connect with the video unit, he says.

"Often, it is very difficult to drive a patient many miles to see a specialist," Marcin says. "Telemedicine is a key to access a specialist who can assist in a diagnosis and offer the best possible treatment plan for a patient."

Rural EDs are less likely to have access to pediatricians, pediatric subspecialties, and ancillary services. An Institute of Medicine study found that children account for 27% of all ED visits, but only 6% of EDs in the United States have the necessary supplies for pediatric emergencies, Marcin says.

The hospital also has a "family-link" program that helps families stay connected when a child is hospitalized. Using a special camera and phone unit, the link lets parents see and talk with children in a hospital.

Besides handling emergencies, the UC physicians provide specialty and intensive care consultations. The result has been higher patient satisfaction scores, Marcin says. UC Davis is evaluating patient satisfaction, but records show that a majority of families consider telemedicine extremely important, he says.
Overall, telemedicine can be a solution to the projected physician shortage problems, Marcin says.

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