Truro ER tests virtual visits to cut wait times
Pilot program has treated 175 patients who have urgent issues that are not life-threatening
The hospital in Truro, N.S., is testing out a new way to move patients through the emergency department faster by giving them an option to meet with a physician virtually.
Eight physicians at the Colchester East Hants Health Centre are using high-tech equipment that can help them monitor vitals when they are working from home and assess their patients.
A nurse or paramedic is in the room with the patient to help with the physical assessment.
"Those are patients who have stable vital signs or minor injuries or ailments that would require urgent attention — within 24 to 48 hours — but not necessarily life-threatening issues," said Dr. Jan Sommers, chief of the emergency department.
"We have a clinical assistant who can touch or feel a patient's belly or they can describe temperature change. We have very sophisticated video technology to provide an up-close look at skin changes, breathing patterns — just the overall appearance of the patient."
Sommers and her team first ordered the equipment at the beginning of the pandemic and used it to treat patients with COVID-19.
She said they started to come up with other ways to use it, and eventually decided to pilot this program in an effort to cut wait times in the emergency department.
"It certainly is a learning curve. As each week goes by, we identify things we can change," she said.
The patients they've treated so far have needed prescriptions or referrals.
But Sommers said she was surprised to see how well the system worked for patients who have been triaged with more serious concerns, such as stomach pain. She said that can be anything from constipation to appendicitis.
"It's not always obvious from a patient's vital signs or their initial history of triage," she said. "Is it safe to assess patients in this way? There's early indication that it is safe."
'An extra tool'
All the patients who qualify are given an option of trying out the pilot program, but they can always ask to see a doctor if they change their mind or if they are not satisfied with how it went.
Doctors also flag when a patient needs to be seen in person.
"It's not either-or. This is meant to be an extra tool in our tool kit," said Sommers.
Right now, Sommers said eight physicians at the hospital are taking part and treating patients while they work from home.
Some, she said, live an hour away from the hospital, so this provides a workaround if the emergency department sees a spike in patients one day and it needs extra help.
"You may not want to work necessarily 16 shifts in person, but the virtual care shifts just feel different. There's fewer interruptions, less noise," said Sommers. "In some ways, it can be a more satisfying interaction with the patient because the environment of the emergency room just poses challenges in itself."
The program started in mid-February, and the hospital has now treated about 175 patients virtually.
Sommers wants to test the program for at least a year. She said ultimately, it could be a solution for short-handed hospitals, especially while there's an ongoing doctor shortage.
"I think generally people have been satisfied with the experience," she said.