Johns Hopkins Hospital aims to reduce ER wait times through telemedicine program

Program expanding to two other Hopkins Hospitals

BALTIMORE, Md. - The average wait time at emergency rooms across the country is 24 minutes. The Pro-Publica wait watcher tool shows that number nearly doubles in Maryland hospitals.

Johns Hopkins is working to cut down delays by enabling doctors to visit with patients virtually.

Their telemedicine program in the emergency department was in development for a year and a half before it was launched at Johns Hopkins Hospital in April. The program is now expanding to two other hospital centers at Johns Hopkins Bayview Center and Howard County General Hospital.

“We get consent from [the patient], make sure they're okay to see a provider on-screen. We speak to the patient and not just speak to the patient, but we're also able to examine the patient. So I can listen to the breath sounds, listen to the heart sounds, I can use the camera to look in the throat or the ears, so a lot of things that we do very early on in the screening process we can do it from home,” said Dr. Junaid Razzak, a professor of emergency medicine at Johns Hopkins Hospital.

The way it works is a patient walks into the emergency department. If their condition is life-threatening, they're automatically taken care of, but if it's less severe, the patient waits to first meet with a triage nurse then is sent back to the waiting room to wait for a physician.

“Your limiting factor is the amount of providers that you have or the doctors that are on staff to see the patient. If there are no doctors on staff to screen the patient, the patient will end up waiting until a doctor is available,” said Dennis Gordon, the IT telemedicine manager at Johns Hopkins Hospital.

Now with telemedicine you can meet sooner with a doctor just over a screen versus in-person. And with the help of a certified nursing assistant, the doctor does an exam and creates a plan for care.

The process is voluntary. A patient will also always meet in-person with a doctor before being discharged.

“We have seen almost 1,600 patients now, so we accumulated a significant experience. It has been very useful,” said Dr. Razzak.

Gordon helped specially design the one machine that facilitates the virtual experience throughout the hospital. The technology not only speeds along wait times but is utilized in mass-casualty incidents.

“With this cart we're able to activate a doctor within 30 seconds, order meds, order tests and get their plan of care started,” said Gordon.

Doctors can start work as soon as they're called. Work stations have been installed in their homes so they can securely connect with patients.

“So, that patients don't have to wait for too long and we don't have to bring in providers at off hours, so it's working for both of us,” Dr. Razzak said.       

Gordon added that patients and physicians have been receptive to the process and soon the program will be operational at Johns Hopkins Bayview Center and Howard County General Hospital. The same physicians at Johns Hopkins Hospital will be able to work virtually in different hospital centers.

“Can we use this technology to improve quality of care for our community and our patients? Yes. And that's what this does, it fills that need,” said Gordon.

While they’ve seen success, Gordon said there are roadblocks in implementing telemedicine into every emergency department. HIPAA, FDA, and government regulations make it difficult to put a machine in a hospital. There are privacy and safety concerns, but groups are working to pass new legislation to expand telemedicine use.

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