🤕Overcrowded and understaffed: An ER dilemma

What’s in for today:

• Why the long wait times?

• AI in healthcare: AI-powered “black-boxes”?

• Abortion access, $4.8 trillion healthcare cost, and medical debt

LET’S TALK!

The problem of long wait times

Ruth’s experience is not unique. Long wait times in ERs are a common issue. In fact, CMS data from April 2022 - March 2023 estimates that the median time patients spent in the ER nationwide was 162 minutes, with the longest visit time at 744 minutes! That’s over 12 hours!

Why though?

There are different reasons why ER wait times are so long:

• Firstly, the emergency room is the point of admission to the hospital. If the hospital is at full capacity, with no available beds, there is nowhere for patients to go.

• In the ER, patients are prioritized based on the severity of their conditions. In the U.S., a common triage system used is the START (simple triage and rapid treatment) system. This system takes various criteria into consideration, such as the patient’s pulse, presence of bleeding, respiratory rate, and ability to follow commands. While this ensures that patients with life-threatening conditions are treated first, it also means that patients with less critical issues may have to wait longer.

• ERs are designed to handle urgent and life-threatening conditions. However, ERs often become a catch-all for all medical concerns. Many people go to the ER for non-emergent issues because they can’t easily see a primary care doctor or because the wait times to see one are too long (conversation for another time). This leads to a buildup of patients in the ER.

• Last but not the least, limited staff and resources. Like other departments in healthcare organizations, ERs are often understaffed with nurses and doctors stretched thin.

  

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Impact

For patients, long wait times can be physically and emotionally taxing. Prolonged pain and discomfort, and the uncertainty of when they’ll be seen can create a distressing experience.

When patients wait longer, their condition is more likely to get worse, leading to higher healthcare costs. A study found that extending the wait time for a patient with a serious condition by just 10 minutes can increase the hospital’s cost of care for the patient by an average of 6%.

Healthcare workers are equally affected. Overworked staff can lead to burnout, impacting their ability to provide high-quality care. The constant pressure to manage high patient volumes with limited resources can lead to mistakes and reduced job satisfaction.

What is being done?

There isn’t one perfect solution to solve this problem. However, healthcare organizations are developing new and creative ways to lessen the impact of this problem/ Here are a few examples:

• Hospital redesign: The University of Pennsylvania Hospital’s $1.6 billion redesign has significantly reduced emergency room wait times. The hospital restructured its emergency department by having doctors evaluate patients immediately upon arrival and directing them to treatment areas, rather than using exam rooms as waiting areas.

• Self-Check-In Kiosk: This study found that wait times in EDs with kiosk self-check-in were 56.8% shorter compared to EDs without kiosk services.

• Self-Scheduling: A Michigan-based hospital implemented ED self-scheduling and successfully reduced its wait times.

Why should you care?

Waiting in the ER can feel like an eternity. Knowing why it takes so long can help us make better choices when we need care. If it’s not an emergency, think about going to urgent care centers. or use telemedicine services. This can make it easier for ERs to help those with life-threatening emergencies more quickly. Remember, the ER staff are doing their best, so let’s show them some kindness next time we visit. 😉

TRACKING: AI IN HEALTHCARE

• The University Hospitals network in Cleveland, Ohio, has implemented Aidoc’s AI platform, aiOS™, across 13 hospitals and many outpatient locations to enhance patient care and operational efficiency. This deployment aims to improve patient outcomes and streamline workflows by leveraging AI algorithms to analyze CT scans, prioritize urgent cases, and support care teams with critical information.

• Researchers have created an AI program called PheNet, which can identify individuals at high risk for rare diseases such as common variable immunodeficiency (CVID) years before traditional diagnostic methods. By analyzing ERHs, PheNet successfully pinpointed 74 out of 100 high-risk patients as likely CVID cases, potentially speeding up treatment and reducing associated healthcare burdens. This study illustrates the potential of AI enhancing early diagnosis and outcomes for patients with rare diseases.

• Hospitals are using AI-powered “black boxes” in operating rooms to enhance surgical safety and outcomes, with systems like the one developed by Dr. Teodor Grantcharov recording and analyzing surgical data. Despite some employee resistance due to privacy and legal concerns, the technology is in use at nearly 40 institutions, including major health systems like Mayo Clinic and Mount Sinai, aiming to improve surgical standards akin to aviation safety improvements.

POLICY & INDUSTRY NEWS

🩺Abortion Access: The Supreme Court rules unanimously to protect access to a medication used in nearly two-thirds of U.S. abortions. The ruling stated that abortion opponents did not have the legal right to sue over the FDA’s approval of the medication, mifepristone, and its subsequent actions to ease access to it. This decision ensures that mifepristone remains accessible across the country.

🏥Healthcare Cost: U.S. healthcare spending is projected to have increased to 7.5% (from 4.1% in 2022) in 2023 to reach $4.8 trillion. Over the next decade, healthcare spending is expected to grow faster than GDP, leading to a rise in health spending’s share of GDP to 19.7% by 2032.

🥼The Consumer Financial Protection Bureau (CFPB) has suggested a new rule to remove medical debt from credit reports. This change would affect approximately 15 million individuals, boosting their credit scores. However, debt collectors are against this proposal, expressing concerns about potential challenges for medical professionals in getting paid for their services.