Telehealth is not new to the emergency department, but at least one health system has found a novel way to deploy it. Next month Banner Health is launching a teletriage program in its high-volume emergency departments in the Phoenix area with a threefold mission: to relieve pressure on staff, to make sure patients don’t leave without service due to long waits, and to provide the most appropriate treatment at the lowest cost.

When patients visit the triage nurse, low-acuity individuals also interact with a nurse practitioner via a telehealth monitor located in the same room. The triage nurse takes vitals and observes interactions, so the patient won’t have to repeat information should they require traditional emergency services. If appropriate, patients are treated on the spot or redirected to urgent care services provided in a separate area of the facility.

A pilot study demonstrated that the program could reduce time in the department by two hours, says Natalya Faynboym, MD, CPE, executive director of Banner’s innovation think tank, Imaginarium.

This approach will offer “substantial cost reduction for almost everybody involved, ” says VanderWerf, including the patient, provider, and payer. While the pilot demonstrated significant savings, he says, figures have not been projected due to the short time frame of the test period.

Banner also plans to test a completely different concept in emergency care: at home observation. Somewhat similar to hospital at home programs, the pilot will send home select Medicare Advantage patients who have been assigned observation status. In addition to a home visit by healthcare personnel, the patient will be monitored via a tablet and peripheral devices, and have two-way communication with telehealth providers.

The goal is to provide care in an environment where the patient is more comfortable, evaluate the financial implications, and possibly eliminate the unexpected charges the patient bears when assigned observation status.

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