According to the Centers for Disease Control and Prevention, the average “door-to-doc” ER wait time nationally was 58 minutes in 2009. Even in an ER with a shorter-than-average door-to-doc wait time, there’s no telling what wait a given trip can incur — until now, that is.
Thanks to technology already used daily by millions of people, two San Jose hospitals are the first in northern California to make their actual ER wait times available to the public via text message. Users simply text “ER” to 23000 from a cell phone and reply with their location (Zip code) to receive current wait times at Good Samaritan Hospital and Regional Medical Center of San Jose.(These wait times are also posted on both hospitals’ websites.)
The text message program works using a technology that links computer systems in the ER with the texting abilities of cell phones, allowing the texter to see exactly how long recent patients have waited to be seen by a physician or associated provider. The wait time displayed reflects the elapsed time from patient arrival in the ER to being seen by an ER provider in the previous four hours, and wait times are updated every 30 minutes. The wait time text also gives users a toll-free number to call to speak with a nurse.
The texting tool relates closely to two other programs both hospitals use: Consult-A-Nurse, where callers can speak directly with a registered nurse who can provide clinically educated recommendations based on information from the caller; and iTriage, a free smartphone app that, by inputting the user’s Zip code or having the app cue off GPS, provides a full list of all the hospitals nearby, listed in the order of their distance from the user’s current location.
From Talk to Text
“Good Samaritan Hospital, like many other hospitals, especially those within Hospital Corporation of America [HCA], has been working hard to reduce wait times and the total amount of time patients spend in the emergency department,” explains Richard Newell M.D., Medical Director, Emergency Department, Good Samaritan Hospital. “As we made progress, national statistics seemed to indicate that we were able to provide timelier emergent/urgent health care than some other hospitals, and that this might offer a competitive advantage. Our goal was to have [ours] be under 30 minutes.”
According to Dr. Newell, a pilot project in some of HCA’s Florida hospitals showed that when patients with minor ER needs could see the wait times for five or six hospitals within close driving distance, they chose the hospital with the shortest wait time, which helped those emergency departments balance patient loads. In addition, anecdotally speaking, some people seemed to choose one of the ERs reporting wait times simply because they had information about those wait times, which can provide those facilities that report wait times an opportunity to help more patients in need.
“Here in Silicon Valley, most people are used to using technology to do much of their personal business (i.e. find the nearest gas station, make reservations, pay bills, etc.). Health care should be no different,” notes Elaine Nelson, M.D., Medical Director, Emergency Department, Regional Medical Center of San Jose, where the door-to-doc goal is 20 minutes or less. “When you are able to do that consistently, you want potential patients to know,” she adds.
“If you’ve ever been sick or injured, you know that you want to be treated as quickly as possible,” explains Dr. Nelson. “Why wait longer in one ER when there could be a shorter wait in an ER just a few miles away? This gives people information to make the best choice for their circumstances. It can also help balance ER loads. If you’re about the same distance from two hospitals and can see a shorter wait time at one, your choice to go to the less busy ER helps reduce pressure on the busier ER.”
Regional Medical Center of San Jose is a Level II trauma center and holds The Joint Commission’s advanced certification as a Primary Stroke Center and a Get With the Guidelines – Stroke Gold Plus Performance Achievement Award from the American Heart Association/American Stroke Association. It is a certified Chest Pain Center, and county-designated STEMI Receiving Center. The emergency department sees approximately 65,000 patients per year, and as a Level II trauma center, it sees approximately 2,000 trauma patients per year.
Good Samaritan Hospital is recognized regionally for acute and tertiary services — including its Level III neonatal intensive care unit — and is an Advanced Primary Stroke Center, certified Chest Pain Center, county-designated STEMI Receiving Center and accredited Comprehensive Community Cancer Center. The emergency department treated 47,000 patients in 2009. Patients are triaged on a scale of 1 to 5, with Level 1 representing the sickest patients with conditions that threaten life or limb and require immediate aggressive interventions, and Level 5 representing the least ill patients. Year to date, 1% of its ER patients were Level 1; 12% were Level 2; 55% were Level 3; 30% were Level 4; and 2% were Level 5.
Targets and Trends
Both hospitals spread the word about this new feature via print ads, television and radio coverage, and a direct-mail campaign to more than 70,000 households in the primary and secondary service areas for the two hospitals, including San Jose, Santa Clara, Campbell, Los Gatos, Saratoga, Monte Sereno and Milpitas.
“Given that we live in the heart of Silicon Valley with many of the largest and most advanced technology companies, it only makes sense that we utilize information technology to improve patient care,” observes Dr. Newell.
In the first month, the texting option was available, both hospitals reported increased traffic to their websites, and more than 1,000 people texted for ER wait times.
Drs. Newell and Nelson agree that the texting option is recommended for those with minor illnesses or injuries, such as weekend warriors who pull a muscle or sprain something, the handyman or home gardener with a minor injury or the parents with a baby who is sick enough to need medical attention out of office hours but who is not dangerously ill. It’s also a great tool for anyone who is visiting the area, as well as residents who do not have a physician. “This is definitely not a service for people who are seriously ill, injured or people who might be having a heart attack or stroke,” observes Dr. Nelson.
This texting tool is one way both Good Samaritan Hospital and Regional Medical Center of San Jose work to provide quality care to their community.
“Just like we’re willing to have independent outside agencies judge how well we do with the most complicated care, we are willing to let our patients take a look at how well we do with their less critical needs,” observes Dr. Newell. “I think having the availability to publicly report our ER wait times tells patients that we are here for their urgent care needs, as well as those conditions that everyone knows us for.”
“Assisting people to find high-quality care when they need it most is an extremely valuable service, and publishing our wait times will help facilitate that,” concludes Dr. Nelson.
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