Tapping tech to cut ER waits
To click through an online search of health care news in Ontario is to run a gauntlet of concerning headlines about the shortage of family doctors and nurses, about the closures of emergency departments, the expansion of wait times and the creep of privatization into our increasingly fragile publicly funded system.
Then, click through a search on artificial intelligence (AI) and the worry will grow about the perils of fake news, doctored photos and videos, the loss of jobs in fields ranging from writing, music and acting to finance, architecture and agriculture.
We are facing real concerns in health care as well as the cascading impact of the underregulated technology industry.
That is why it is a relief to come across a recent headline in the Star that trumpeted how AI and virtual emergency department (ED) hospital visits were being used as tools “to cut bloated wait times.”
Health reporter Kenyon Wallace reported that “long wait times, increased patient volumes and old infrastructure built for a different time, to name just a few challenges, have pushed emergency departments and their staff to the breaking point.”
As just one example, Wallace reported it took an average of 23.3 hours for patients admitted to hospital to receive an in-patient bed.
It is rare these days to find a story that pushes through the dark headlines and offers a ray of hope for our health care system.
Wallace interviewed leaders from four Toronto hospitals — University Health Network (UHN), Sunnybrook Health Sciences Centre, SickKids hospital and Michael Garron Hospital — about their use of technology to improve patient experiences.
What he found is one prescription for improving the health of the urgent care sector.
The first example was how virtual emergency departments are cutting wait times in the real ones.
The restriction of in-person hospital visits during the COVID-19 pandemic required doctors and nurses to assess certain types of patients online, a practice that is becoming more established. UHN, for example, now sees upwards of 250 patients this way per month while Sunnybrook is treats about 300 per month. Studies show this has taken pressure off the physical emergency departments.
The second example of how technology is improving wait times is at SickKids. Researchers programed AI into an app to determine which patients are most urgently in need of care. The app can also send patients information about their condition so they can improve their health literacy before seeing a physician.
Meanwhile, Michael Garron Hospital is experimenting with online emergency department bookings. On the hospital’s website, patients are presented with a list of criteria to determine if their condition allows for a short wait before receiving care. Patients are then presented with 10 to 12 appointment options at times that tend to be less busy.
To date, almost 4,500 patients have used the program and there’s capacity in the system for more daily appointments. Michael Garron has among the lowest wait times in the city, despite having one of its highest volumes of patients.
Finally, Sunnybrook is using an AI algorithm to determine wait times depending on the number of patients waiting to be seen by a physician for the first time and the total number of patients in the emergency department. The tool is updated every 15 minutes. “Some patients have commented that it provides them not only with an expected wait but a greater appreciation for how busy the department is,” says Dr. Justin Hall, chief of Sunnybrook’s emergency department. The hospital also uses the tool and its data points to boost staff at more demanding times.
The nature of the news business is that good news stories are rarely sexy. The phrase “if it bleeds, it leads” was coined by William Randolph Hearst as far back as the 1890s, but in these polarizing times where political leaders attract voters with the mantra that everything is broken, we need to lean in to the good stories.
Given the incredible hardships that emergency department are facing, Wallace’s story proves there remains a commitment among emergency department staff to improve the patient experience and determined to make a difference.
Artificial intelligence is one prescription for improving the health of the urgent care sector