In the past 24 years, I’ve found myself sitting in the emergency room (ER) on three separate occasions – a broken wrist in middle school, appendicitis in high school, and pneumonia in college. Like many patients, I checked in at the registration desk and anxiously waited for my last name to be called by the triage nurse. While the amount of time I waited to be treated varied for each visit, I vividly remember sitting in the waiting room, unsure of how much longer it would be until my name was called, hoping the nurses hadn’t forgotten about me.
Last week, in my first days of my Health for America (HFA) at MedStar Health fellowship, I found myself in the ER for a fourth time. Only this time, I was at MedStar Washington Hospital Center’s ER to observe teletriage, a process that I believe directly impacts patient experience.
What is teletriage?
Teletriage is an example of MedStar Health’s telehealth offerings, allowing triage nurses to remotely and securely video call a physician from the ER. Similar to Skype, the triage nurse logs into the computer system, initiates the video call, and talks to the physician via a webcam. Once the physician answers the video call, the triage nurse introduces the patient and allows the patient to speak one-on-one with the physician via the webcam.
MedStar Health currently uses teletriage during peak times in the MedStar Washington Hospital Center and MedStar Good Samaritan Hospital emergency rooms.
How does teletriage relate to patient experience?
Patient experience is shaped by a wide range of factors, from overall patient satisfaction to patient engagement. During my previous ER visits, my patient experience was primarily based on two measures:
How long I waited to be seen by a physician.
Whether I received a definitive diagnosis and treatment.
In a traditional ER setting, a patient doesn’t interact with a physician until they are taken back to an ER room (after the triage process). In the teletriage model at MedStar Washington Hospital Center, the patient has a chance to interact with a physician during the triage process. The physician is then able to place orders for medications, blood work, x-rays, etc. Doing this expedites the treatment process once the patient is brought back to a room and reduces door-to-doctor wait times.
While door-to-doctor wait times are not the only factor that impacts patient experience, it is a measure that has previously been researched in relation to patient experience. In addition, ER wait times are actively being incorporated into upcoming ER-specific patient satisfaction surveys, such as the Centers for Medicare & Medicaid Services Emergency Department Patient Experiences with Care (EDPEC) Survey.
Reflections on my shadowing experience
One of my favorite aspects of the HFA fellowship curriculum is the program's emphasis on immersing fellows into experiences that are centered around a patient's healthcare journey. Whether it be patient interviews, simulations, or shadowing, the fellowship curriculum challenges us to understand what it's like to be a patient in today's healthcare environment.
My recent shadowing experience at MedStar Washington Hospital Center provided insights into ways in which video-based services impact the patient-provider relationship and experience, as well as how health communication flows over video. As I continue my HFA fellowship, I will seek out additional shadowing opportunities that will help answer the question of how telehealth impacts patient care and health care overall.
*To learn more about the teletriage process at MedStar Washington Hospital Center, review recent news coverage here and here. Continue following the HFA blog for biweekly perspectives about the 2017-18 fellowship.