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The secret to New York Presbyterian's 2-hour drop in ED patient wait times? Telehealth.

April 9, 2018

    Editor's note: This story was updated on February 12, 2019.

    New York Presbyterian's (NYP's) telehealth Express Care program has received a lot of press for its nearly five-fold reduction of the hospital's emergency department (ED) wait times.

    Get 6 steps to ED transformation

    By diverting select ED cases to an onsite virtual visit, the program has slashed low-acuity patient wait times from two and a half hours to just thirty minutes. It's also managed to attract patients beyond traditional telehealth users (20% of its users are over 60 years old), and keep ED revisit rates at about half the national average. And by shifting low-acuity patients to other platforms, ED staff can focus on emergent cases.

    Thinking of rolling out your own telehealth solution to offload low-acuity volumes at an urgent care center or ED? Read on for three best practices we've learned from this program:

    1. Integrate the program into standard care pathways

    To smooth transfers and minimize disruptions on existing triage processes, ED staff built Express Care triage protocols into their routine clearance process. Nurses evaluate whether patients are eligible for Express Care during their routine initial examination. Patients can opt to participate after being screened—and program leaders say most eligible patients often do participate in the interest of reducing wait times. Those that choose virtual visits are then diverted to rooms equipped for visits with ED physicians located across the health system, with clearly displayed discharge and pharmacy pickup instructions.

    2. Offer virtual options in terms that patients actually care about

    Our Virtual Visit Consumer Survey found that saving time was one of the most compelling drivers for consumers to try a virtual visit. In fact, when in-person wait time increases, so too does the average patients' willingness to try a virtual visit as an alternative. Close alignment with consumer preference is key to NYP's success: The program isn't just targeted to solve a hospital need (ED capacity relief)—it's also tailored around a popular tradeoff most consumers are willing to make: time savings in exchange for virtual care.

    3. Use system doctors to mitigate common patient concerns about virtual visits

    The top concern patients cite when considering a virtual visit is the quality of care, followed by the risk of having to still go to a physical clinic because the provider can't fully treat them virtually. Because Express Care uses only in-house doctors and the program is located on-site, NYP's model mitigates these top barriers to trying a virtual visit. This is an important way to increase utilization of virtual visits while also keeping patients comfortable with doctors from a system they trust.

    By building in steps to safeguard patient comfort and maintain a consistent experience, New York Presbyterian is able to take advantage of telehealth to meet ED demand and maintain a high-quality patient experience, all with one of the largest-scale virtual ED visit programs of its kind.


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