Pandemic Helps Point Way to Easing Crush At Emergency Rooms
The pandemic may present an opportunity to reshape the future of emergency medicine.
The coronavirus has already prompted health care leaders to rethink how to deliver care to make the most of available resources, both physical and digital. If the shift to greater use of telemedicine continues after the pandemic, it could reduce reliance on the emergency room, where crowding has long been a problem.
This could happen if telemedicine increases the ability for doctors to see more patients more quickly. A Veterans Health Administration study found that same-day access to primary care was associated with fewer emergency visits for conditions that weren’t true emergencies.
During the pandemic, educational campaigns have tried to raise awareness about telemedicine, offering guidelines on when people should seek immediate attention and when an online consultation is adequate. And American Medical Association officials are seeking to keep the regulatory flexibility on telemedicine that has been allowed during the pandemic.
Of course, telemedicine isn’t a solution for every health problem. And patients with limited digital fluency and access may get left behind as reliance on telemedicine grows. But the potential payoff is large: A review of medical records of older patients found that 27% of emergency room visits could have been replaced with telemedicine.
According to the American College of Emergency Physicians, more than 90% of emergency departments are routinely crowded, which has long been recognized as problematic.
On average, a patient visiting an emergency room will wait about 40 minutes. 17% of patients visiting an emergency department in 2017 waited over an hour.
As many studies have documented, longer wait times can be harmful. For some conditions, a systematic review in 2018 found, longer waits are associated with lower-quality care and adverse health outcomes that include increased mortality. One study found that crowding in the emergency room is associated with a longer wait for antibiotics for pneumonia patients.
“Early antibiotics are critical for a number of common and serious conditions treated in the ED, including pneumonia,” said Dr. Laura Burke, an emergency physician with the Beth Israel Deaconess Medical Center in Boston. “Patients who have delays in antibiotic treatment have higher death rates.”
文／Austin Frakt 譯／陳韋廷 核稿／樂慧生