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Consumers Are Avoiding the ER – But Not in Favor of Telehealth


(mHealthIntelligence) – Hospitals and health systems are launching direct-to-consumer telehealth platforms to push people with non-acute health concerns away from the emergency department and toward virtual visits. But while new research suggests ED traffic is decreasing, consumers are instead flocking to urgent care and retail clinics.

In a study of ED patterns from 2008 to 2015, researchers at Boston’s Brigham and Women’s Hospital found that ED visits decreased by 36 percent over that time, while visits to non-ED venues surged by 140 percent. But that increase consisted primary of traffic to urgent care centers (119 percent) and retail clinics (214 percent).

Telemedicine is fast. No more waiting rooms; connect to a doctor instantly via phone or email.

For telehealth, meanwhile, the number of ER visits replaced by a virtual consult jumped from 0 in 2008 to six in 2015.

The study, posted online in JAMA Internal Medicine, indicates consumers are becoming more comfortable with seeking alternatives to the ED for non-urgent care, but they’re still more comfortable with in-person care than a telehealth or telemedicine platform.

“The drop-in emergency department visits are quite striking and represent a substantial shift in where patients go to get care for conditions such as sore throat and minor injuries,” Sabrina Poon, MD, MPH, who was an emergency physician and research fellow at BWH when the research was conducted, said in a press release issued by BWM.

“The observed increase in visits for treatment of low-acuity conditions was primarily associated with an increase in visits to urgent care centers, which are now the acute care site at which low-acuity conditions are most commonly treated,” the study noted. “Possible reasons for this recent increase include an increasing number of clinics, familiarity and acceptance of urgent care centers as credible alternative venues for unscheduled care for acute conditions, the ability of urgent care centers to treat a wider range of conditions than retail clinics or telemedicine, greater convenience with shorter wait times than EDs, and lower out-of-pocket costs for consumers.”

The BWH study touches on a trend among hospitals and health systems to shift unnecessary traffic out of the ED and into alternative care, reducing the strain on overcrowded and understaffed emergency departments and giving consumers more timely and less expansive access to care. That’s the reasoning behind the direct-to-consumer telehealth movement.

But for the past couple of years, some healthcare executives have lamented that they’re virtual care service isn’t catching on as quickly as they’d like.

“Utilization does take time,” Peter Antall, founder and chief medical officer of the Online Care Group at American Well, a partner in platforms launched by, among others, Nemours Children’s Hospital, Intermountain healthcare and the Cleveland Clinic, said at a 2017 American Telemedicine Association conference panel discussion. Healthcare providers launching new telehealth platforms, he said, should expect anywhere between 5 percent and 30 percent of their patient population to move to digital health at the onset.

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