The Covid-19 pandemic has placed an enormous strain on healthcare services around the world that were already often bursting at the seams.  New research from the University of Texas at Dallas explores how telemedicine might have the potential to reduce demand on emergency rooms.

“This longstanding problem is mainly driven by the imbalance between increasing patient flow and the shortage of emergency room capacity,” the researchers explain.  “While the ER is supposed to be a safety net of the health care system, the overcrowding problem has strained this safety net and posits various threats.”

Reducing congestion

The researchers say that the use of telemedicine in emergency rooms is distinct from that in home-based settings.  For instance, patients still present in the ER, but they are connected to off-site physicians via the telemedicine platform.

“Off-site physicians can be within the same hospital, in a different hospital, or even at home, as long as they can connect with emergency patients through videoconferencing tools and have access to patients’ health records,” the researchers explain.

The researchers used data from all emergency visits in New York state between 2010 and 2014, and found a significant reduction in the average length of stay and wait time when telemedicine was used in the ER.

The technology was found to improve the on-call physician’s general efficiency by removing any mobility requirements, while also smoothing out their workflow.  All of this results in shorter waiting times for patients.

The approach was then replicated across the United States, with similar findings emerging that telemedicine in the ER reduces average wait times, and the amount of time spent in the ER.

Resource allocation

The researchers highlight how a key benefit of telemedicine is the efficient allocation of resources and information.  This is crucial in emergency rooms that often suffer from shortages of manpower, whether due to excess demand or simply lacking certain expertise.

“Although the ER seems to be an unlikely place for telemedicine to play its role, it is happening, and in fact, is very promising,” the researchers say. “We believe our findings are critical for ERs, considering the unique setting of unscheduled arrivals and unpredictability of patient traffic.”

What’s more, this improvement in care delivery was not found to come at the expense of either the cost of delivery, or it’s quality.  It’s a finding the researchers believe may encourage healthcare providers with the incentive to change how ER care is delivered.

“Due to the lack of evidence and the inflexibility of reimbursement policy, the adoption rate of telemedicine in the ER remains low and is growing only slowly,” they explain. “Policymakers can incentivize adoption of ER telemedicine by reducing regulatory barriers, such as lifting restrictions regarding cross-state practitioners’ licensure and providing better reimbursement coverage.”

What’s more, the researchers also believe that telemedicine can help to reduce the health inequalities that exist due to the uneven spread of resources around the country.  By creating a resource-sharing network, telemedicine could help to facilitate the availability of key skills in all locations, and thus reduce healthcare access disparities.