Does Your Health System Need a Virtual Emergency Department?

At Ochsner Health, about 70% of the patients who have engaged with the health system's virtual emergency department have avoided emergency room visits.

Emergency room crowding is a challenge for health systems and hospitals across the country. Creating a virtual emergency department is a relatively new concept to address the problem, and it's a concept that Ochsner Health is turning into strategy.

Ochsner started its virtual emergency department in October 2024. The virtual emergency department is staffed by a board-certified emergency medicine physician and nurse navigator from 8 a.m. to 8 p.m. seven days a week.

So far, the virtual emergency department has worked with 13,000 patients. In 70% of these cases, patients have been able to receive care without visiting a brick-and-mortar emergency room.

"Originally, the concept came out of our overall journey to try to get patients to the right care in the right place," says Lisa Birdsall Fort, MD, system medical director of quality for emergency services at Ochsner. "We found that we had disproportionate ED utilization, so we needed a solution to help to make sure that we were able to connect patients to the right care."

From a CMO's perspective, the virtual emergency department program generates strategic, clinical, and financial value, according to Sidney "Beau" Raymond, MD, CMO of Ochsner Health Network. It improves access and convenience by allowing patients, particularly those with low-acuity conditions or living in rural areas, to receive timely care from emergency physicians without needing to physically visit the emergency department.

"This model enhances cost efficiency by reducing unnecessary ED visits and redirecting patients to more appropriate ambulatory or virtual care settings, which ultimately lowers overall healthcare spending," Raymond says. "Additionally, the program helps optimize resources by preserving high-acuity ED capacity for true emergencies, thereby improving throughput and reducing burnout among emergency staff."

The virtual emergency department addresses several pain points for CMOs, including alleviating ED crowding by offering patients more appropriate access points for care, Raymond explains.

"Many patients choose the ED for convenience or payment flexibility, but the virtual emergency department provides a viable alternative that maintains accessibility while improving care flow," Raymond says. "The program functions as a centralized hub, guiding patients to the right care setting, whether that be virtual, urgent care, primary care, or even specialty follow-up."

For patients, the virtual emergency department elevates patient satisfaction and outcomes by reducing wait times, improving care navigation, and offering personalized treatment plans, Raymond says.

Sidney "Beau" Raymond, MD, is CMO of Ochsner Health Network. Photo courtesy of Ochsner Health.

How Ochsner's virtual emergency department works

Patients are referred to Ochsner's virtual emergency department from primary care offices, specialist offices, urgent care centers, or the health system's nurse-on-call line, according to Noah Pores, MD, medical director of the virtual emergency department.

"If patients are triaged in such a manner that emergency care is felt to be needed, the virtual emergency department will be consulted through the Epic secure chat platform," Pores says. "From there, we engage with providers in a brief conversation about the case and review medical records such as images and laboratory results."

The virtual emergency department makes a care recommendation for patients based on the conversation with their providers, Pores explains.

"We ask questions of physicians or nurses, depending on which staff member is consulting with us," Pores says. "Then we make care recommendations about whether emergency care is appropriate."

If it is determined that emergency care is not appropriate, the virtual emergency department has several options to provide care. The patient can be offered a virtual visit such the video teleconferencing platform via Epic. The patient can be offered an e-visit, which is an asynchronous type of virtual visit that involves a survey submission by the patient. In an e-visit, the virtual emergency department physician can review the survey responses and provide services such as prescriptions, ancillary tests, or referrals.

The virtual emergency department also redirects patients to care settings that avoid an emergency room visit.

"We answer questions for patients, and many times the needs that they have can be resolved in the outpatient setting, which they can find difficult to navigate," Pores says. "The nurse navigator is the unsung hero in our virtual emergency department model. Their ability to schedule patients quickly for primary care and specialty clinics has been a game changer for us as a health system."

Noah Pores, MD, is medical director of the virtual emergency department at Ochsner Health. Photo courtesy of Ochsner Health.

The future of virtual emergency departments

Virtual emergency department programs are poised to become a national trend, according to Raymond, who adds that Ochsner's virtual emergency department program uses existing technology to address EDs that are filled with non-emergent patients

"It enables patients to be seen at the most appropriate site of care," Raymond says. "Traditional nurse triage lines, which most health systems use, are limited by protocol. By incorporating experienced ED physicians into the triage process, our virtual emergency department ensures that patients who would otherwise be sent to the ED due to protocol limitations can instead receive the necessary evaluation and management in a more suitable setting."

Health systems and hospitals that are interested in starting a virtual emergency department program should be prepared to apply a significant level of effort, according to Birdsall Fort.

"A virtual emergency department is not something that comes out of a box from an electronic health record vendor—it is a relatively new concept," Birdsall Fort says. "You need to be creative. You need to start the program, then refine what you offer."

It is important for a healthcare organization to establish buy-in for a virtual emergency department program, Pores explains.

"A virtual emergency department requires a lot of coordination across multiple stakeholders, including primary care, executive teams, quality departments, and population health programs," Pores says. "You also need a strong group of physicians who are willing to be engaged in the process."

Lisa Birdsall Fort, MD, is system medical director of quality for emergency services at Ochsner Health. Photo courtesy of Ochsner Health.