More on Telehealth

Utilizing telehealth in the ER can reduce wait times and patient length of stay

Telehealth adoption under COVID-19 has provided a blueprint for wider implementation across ERs and other healthcare venues.

Jeff Lagasse, Associate Editor

Telehealth has become more common given the current global pandemic. COVID-19 has limited doctor's office and hospital visits to ensure safety for as many people as possible. But rather than diminish the quality of care, new research in the INFORMS journal Information Systems Research finds that wider use of telehealth in the emergency room can yield positive results for both patients and providers.

The study, "Does Telemedicine Reduce Emergency Room Congestion? Evidence from New York State," looks at all emergency room visits in New York from 2010 to 2014. The researchers found that, on average, telehealth availability in the ER significantly reduces average patients' length of stay, which is partially driven by the flexible resource allocation.


Overcrowding in ERs is a common and nagging problem. Not only is it costly for hospitals, but it also compromises care quality and patient experience. Authors Susan Lu of Purdue University, Shujing Sun of the University of Texas at Dallas and Huaxia Rui of the University of Rochester said finding ways to improve ER care delivery is important – as long as it actually works.

Adoption of the virtual care platform works best when there's a surge in demand or a shortage of supplies, because it leads to a larger reduction in ER length of stay when those factors are present. 

The team replicated their findings using annual U.S. hospital data and found that ER telemedicine adoption also significantly reduced average patients' waiting time, which suggests that the LOS reduction partially comes from the reduction of waiting time.

The National Hospital Ambulatory Medical Care Survey from 2000 to 2015 found that the number of ER visits in the U.S. increased by more than 25%. This congestion in the ER can have a number of negative implications due to unhappy patients, decreased productivity by doctors because they're overworked, and increased financial costs because of unnecessary tests.

According to information published in February 2019 by the American Hospital Association, 76% of U.S. hospitals use various telehealth technologies to connect patients and providers.

One of the few silver linings of the COVID-19 pandemic is that it has shown hospitals the promise inherent in telehealth adoption, and through the occasionally forced application of this technology it has provided a blueprint for wider implementation across ERs and other healthcare venues, the authors found. 

Policymakers, for their part, can play a role by reducing regulatory barriers that inhibit more expansive use. In some cases this has already happened, as illustrated by the Centers for Medicare and Medicaid Services' waivers on reimbursement restrictions. Measures such as these create incentives that encourage hospitals to adopt telehealth more broadly in their emergency rooms.


Due in large part to the pandemic, telehealth has evolved from an alternative means of care to one of the primary ways in which many patients seek treatment.

That's reflected in the numbers. In 2020, virtual care is expected to account for more than 20% of all medical visits in the U.S., which in turn are projected to drive $29 billion in total healthcare services, according to a September report by Doximity.

Up to $106 billion of current U.S. healthcare spend could be virtualized by 2023. This highlights the high rates of adoption among both patients and physicians, and the impetus felt among providers to offer safe, secure and easy-to-use virtual services as demand for telehealth continues to grow.

Meanwhile, as of last week, providers have 11 additional telehealth services that will be reimbursed by CMS. Medicare will begin paying eligible practitioners for these services immediately and for the duration of the public health emergency. These new services include certain neurostimulator analysis and programming services, plus cardiac and pulmonary rehabilitation services.

The Business of Health

This special collection of stories, which will be updated throughout the month, explores how hospitals, health systems and physicians are attempting to not only financially survive, but thrive, under the new normal.

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