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Volume 9 Journal of Health & Medical Informatics
ISSN: 2157-7420 Medical Informatics 2018
July 05-06, 2018
July 05-06, 2018 | Berlin, Germany
6th International Conference on
Medical Informatics & Telemedicine
LEVERAGING TELETRIAGE IN AN URBAN EMERGENCY DEPARTMENT TO IMPROVE
PATIENT FLOWAND EXPERIENCE
Aditi U Joshia , Frederick Randolpha, Anna Marie Changa, Megan Sabonjiana , Frank D Sitesa, Alexander P Ambrosinia and Judd E Hollandera
aThomas Jefferson University, USA
Background: Overcrowding in emergency departments leads to increased wait times and patients leaving without treatment,
resulting in delayed care and a decrease in patient satisfaction. We and others have successfully implemented a physician in
triage model to decrease left without being seen (LWBS), improve flow metrics and increase patient satisfaction. However,
these programs have a significant cost associated with them. We studied whether a telemedicine physician could successfully
be used to improve LWBS and door to provide time in an urban academic affiliated community hospital ED.
Methods: We conducted a before and after study. During the intervention period, an On-Demand Telemedicine provider was
utilized to triage patients remotely in an urban community hospital emergency department. Tele-triage was conducted from
11am - 6pm, seven days per week. Tele-triage providers performed a brief history and physical, wrote a triage note and placed
orders in the medical record. Our primary outcomes were the rates of patients that left without being seen (LWBS) and the time
to provider (TTP) compared to the same two month period in the prior year (October 10-December 10, 2017 versus 2016).
Data are presented as means with 95% confidence intervals (CI) and medians with interquartile ranges (IQR).
Results: Comparing tele-triage numbers in 2017 versus 2016, there were 6520 vs. 6362 patients who presented to the ED.
Overall, the LWBS rates were reduced to 0.9%; (95% CI 0.6-1.1%) vs. 2.0%; (95% CI 1.6%-2.3%, p<0.001) and the TTP was also
reduced (median 14 minutes, IQR 7.2-27.6 v 22 minutes, IQR 11-44). Compared to prior year, the overall door to discharge
time (138.1 minutes IQR 84.4-215.5 vs. 150 minutes IQR 87-235, p<0.001) and door to admit time (185 minutes, IQR 131.4-
253.2 vs. 192 minutes IQR 138-266.3, p<0.001) was also reduced.
Conclusion: Remote tele-triage for only seven hours per day in an urban community hospital emergency department reduced
overall LWBS and TTP times compared to years prior. It also had a positive impact on overall door to discharge and door to
admit times.
Biography
Aditi U Joshi is an Emergency Medicine Specialist in Philadelphia, Pennsylvania. She graduated with honors from University Of Illinois At Chicago Health Science
Center in 2006. She is having more than 12 years of diverse experiences, especially in Emergency Medicine. She is particularly interested in the issues of patient
access and engagement, provider education and fostering international collaboration. Currently she is the Medical Director of JeffConnect and part of Thomas
Jefferson University Hospital’s Telehealth program.
Aditi U Joshi et al., J Health Med Informat 2018, Volume 9
DOI: 10.4172/2157-7420-C1-021