Northwell Health Operating Successful ER Telemedicine Service

One of the primary purposes the ER on Demand telehealth service is to direct patients to the most appropriate site of care.

Northwell Health's ER on Demand telehealth service has reduced utilization of emergency rooms and urgent care clinics, according to the New Hyde Park, New York-based health system.

Emergency departments are one of the most expensive sites of care. If patients can be treated via telehealth, services can be delivered with higher value.

ER on Demand, which is available to all residents of New York State, was developed in response to the coronavirus pandemic. The telehealth service was piloted with Northwell Health employees in November 2020, then it was offered to the public from 8 p.m. to 8 a.m. Now, ER on Demand is available to the public 24 hours a day, seven days a week.

One of the primary goals of ER on Demand is to determine whether a patient needs to go to an emergency room. To access the service, patients can call 833-556-6784 or download the Northwell Health app. The first point of contact is a certified paramedic, who determines the appropriate level of care. If the patient does not require a trip to the emergency room for life-threatening symptoms such as heart attack or stroke but needs care, the patient is connected within an hour to an emergency medicine physician via video on a smartphone, tablet, or computer.

"Our aim is to meet patients where they are at—help them get the right level of care as easily and affordably as possible," Jonathan Berkowitz, MD, medical director of emergency medical services at Northwell Health, said in a prepared statement. "We get patients of all ages—parents of infants to senior citizens—calling our service. If someone feels they need to go to the ER and is not sure, that's where we can help."

The health system has examined more than 3,000 patient visits through ER on Demand from January 2021 to April 2022, finding that 92% of patients did not need to visit an emergency room or urgent care center. "Our emergency medicine physicians are experts in telehealth, and are comfortable guiding patients through self-exams, such as abdominal or neurological exams or muscular skeletal tests. Patients are increasingly trusting of this modality of care, and appreciate spending more time with their doctors and are happy with outcomes," Berkowitz said.

ER on Demand accepts all types of insurance, but there may be a specialist copay depending on the patient's coverage. If a patient is directed to go to an emergency room, the telehealth visit copay is waived.

ER on Demand services

In addition to diagnosis and treatment recommendations, ER on Demand physicians can send prescriptions to pharmacies, order lab tests, and schedule imaging such as X-rays.

Many conditions and symptoms can be addressed by ER on Demand physicians.

• All issues related to COVID-19
   
• Gastrointestinal symptoms such as heartburn, constipation, diarrhea, minor abdominal pain, and vomiting
   
• General symptoms such as fever, chills, body aches, and fatigue
   
• Urine-related symptoms
   
• Head, eyes, ears, nose, and throat symptoms such as eye irritation, earache, sore throat, sinus pain, and congestion
   
• Musculoskeletal conditions such as minor sprains, bruises, joint pain, and minor back and neck pain
   
• Neurological symptoms such as headache and dizziness
   
• Respiratory concerns such as asthma and cough
   
• Skin conditions such as dermatitis, eczema, cellulitis, rash, bug bites, minor burns, and cuts

If an ER on Demand physician refers a patient to an emergency department, the doctor calls the emergency room to alert the facility's staff. In some cases, ER on Demand physicians will refer patients to follow-up visits with a primary care practice or specialist. The day after an ER on Demand visit, a team member will call the patient to make sure their condition is improving and to answer questions.

Photo credit: Northwell Health

Related: Building a Business Care for Asynchronous Telehealth