The Latest in Remote Presence.

Telemedicine can help unclog crowded Emergency Departments.

There are basically two ways to run an Emergency Department. Most are designed like the Department of Motor Vehicles where you sign in and wait for service. The emerging way is to use the Grand Central Station model, where the ED is the service hub. People don’t hang out at Grand Central; they get quickly routed to the places they need to go.

Today’s most innovative EDs are using this hub approach to better serve patients – and remote presence plays a vital role in that process. For too long, Emergency Departments have seen themselves as the hospital’s front door, not the center of the entire enterprise. But a hub-style ED offers a host of benefits: more efficient workflow, better resource utilization, greater throughput, and higher quality care.

In a hub-style ED, the idea is to quickly triage and route each patient to the most appropriate care setting. How does telemedicine help? For starters, it provides better service for the ED’s most frequent users: behavioral health and pain management patients, plus those who rely on the ED for routine primary care. Because those patients aren’t in critical condition, they often sit for hours waiting to be seen. But with remote presence, they can get high-quality care without clogging up the ED. A remote physician can quickly make an assessment through devices like the RP-7i robot. That means that ED physicians have more time for patients with life-threatening emergencies.

It’s obvious that the most expensive resource in today’s ED is the provider. Highly trained ED physicians and nurses have more pressing things to do than treat sinus infections or try to determine whether a patient is depressed (especially when a behavioral health professional can be reached quickly with remote presence).

So the choice is clear: your ED can either be a plodding DMV or a fast-paced hub capable of delivering higher throughput and better care while improving the hospital’s bottom line.

About 10% of U.S. patients have limited English proficiency. By law, all hospitals that receive federal funds must offer some kind of interpreting service to those patients. Big medical centers usually have an on-staff interpreter proficient in the most needed languages like Spanish. Small hospitals often have to rely on a clumsy “he said/she said” solution, where the patient and provider pass a cell phone back and forth while a translator in a distant city tries to sort things out.

Sometimes an interpreter can’t be found at all – and that can have a negative impact on outcomes. In a recent study at two pediatric ERs, when a nonprofessional interpreter (such as a family member) was involved, there was a lot of miscommunication. And nearly 25% of those translation errors posed potential health risks for the children being treated.

That’s why many healthcare organizations are turning to telemedicine for solutions. With remote presence, hospitals don’t need to hire full-time interpreters because the language experts are available 24/7. Instead of a crackly phone call, patients get face-to-face communication (resulting in fewer errors). And you can find interpreters for a variety of languages, not just Spanish.

Here’s one scenario: Suppose a business traveler from Rio de Janeiro comes to the ER at a large medical center in Los Angeles. They’ve got an excellent Spanish interpreter on staff, but the man speaks Portuguese, not Spanish. The interpreter might get close to a decent translation, but close isn’t good enough in the ER. With remote presence, you can quickly connect the patient with a Portuguese interpreter in Boston.

Because of health reform, patient satisfaction now plays a key role in reimbursement. And a recent study in Annals of Emergency Medicine revealed that patients who had professional interpreters had satisfaction scores that were four times higher than patients relying on family members.

It’s all very simple. Remote presence boosts patient satisfaction, which in turn boosts reimbursement. That’s a language everyone can understand.