Next time you go to an emergency room, take a close look at the person to your left, then the person on your right.
There’s a good chance one of them doesn’t belong.
In theory, about half of all emergency room visits could be handled someplace other than the emergency room, according to Theresa Osborne, MD, medical director for Spectrum Health Medical Group.
And that’s especially the case during the cold and flu season.
“Emergency departments are set up to deal with trauma, life-threatening illnesses, things like that,” Dr. Osborne said.
That’s not to say emergency room workers can’t handle the hordes of care-seekers who trundle through their doors. They can and they do, every day.
But in about 50% of cases, emergency room patients could receive more appropriate and affordable care elsewhere.
Primary, urgent or video visit?
Urgent care and primary care practices are frequently suggested as those better places to receive care for non-emergent situations.
A call to your doctor might get you in for a quick visit same or next day, and visiting an urgent care center will result in care within a couple of hours.
But in light of the recent surge in flu cases, medical experts in Michigan are now encouraging people with symptoms of cold or flu to stay home and seek immediate care through Spectrum Health app video visits.
“Technology has allowed us to bring care to you,” said Joseph Brennan, one of the creators of Spectrum Health virtual care. “For conditions like the flu, don’t bundle up and drive somewhere, don’t pack up all of the kids, don’t sit in a waiting room, and don’t risk getting something else from someone else. Stay home. Stay in bed. Receive the care you need where you are and when you need it.”
Spectrum Health offers 24/7 on-demand video visits through people’s cell phones or computers from the convenience of their homes, dorm rooms, or wherever they find themselves.
It’s as easy as downloading the Spectrum Health app to make an appointment with a Spectrum Health provider. Wait times average 15 minutes.
Amanda Reed, director of operations from Spectrum Health virtual health, said patients often report they appreciate the convenience. Many are initially a bit hesitant about using the service.
“But after the first experience, we receive feedback about how well their video visit went and what a great experience they had,” she said.
Anyone in Michigan may receive care through the Spectrum Health app. The caller does not have to be a Spectrum Health patient.
“They could be traveling here or visiting family,” Reed said. “As long as you are physically in the state of Michigan, you can use (the service).”
Many Spectrum Health patients choose not to make the video call right away. They prefer to schedule it at a convenient time—during their lunch hour or at the end of the day, for example.
“Patients are really excited and really engaging,” she said.
Trending up
Overuse of the emergency department is “high, very high,” Dr. Osborne said.
Spectrum Health’s emergency departments log about 250,000 visits per year, the majority of them at the Michigan Street emergency rooms in Grand Rapids. About 48% of all these visits were possibly avoidable.
“Our numbers are trending up,” Dr. Osborne said. This meshes with American College of Emergency Physicians poll results that indicate emergency visits have increased in the U.S.
“This country is currently relying on the emergency department to meet the need for acute, unscheduled care,” she said. “It’s really disconcerting to a lot of folks. It’s driving up the cost, a lot, for everybody.”
The cost issue is, of course, overshadowed by the need to provide patients with proper medical care in the proper settings, Dr. Osborne said.
“We’re not just trying to reduce use—we want to improve outcomes,” she said.
The average cost of an emergency room visit is more than $1,000; a primary care visit is about $70 to $150; and a Spectrum Health video visit is $45. If Spectrum Health providers ultimately refers a patient elsewhere for care, the video visit is free.
“Clearly, an emergency room visit is much, much more expensive,” she said.
Still, some patients will choose the emergency room as a first option for minor issues because they have no other place to go–no primary care doctor, or perhaps they’re unfamiliar with urgent care.
“A large majority think they have to go to ER right now, for whatever reason,” Dr. Osborne said. “Emergency or not, this is the only place open.”
There are obvious reasons for speeding off to the emergency room, certainly when life or limb is at risk or when the outcome could threaten disfigurement or long-term consequence.
Beyond that, it’s not always so evident.
“We have many options to receive needed medical care, other than the emergency department,” Dr. Osborne said.
I called my primary was told to go to urgent care it was not open so I ended up in the emergency dept..I had a severe case of gastroenteritis and was given nausea medicine. I did the right thing and ended up in the emergency department because I couldn’t get in to see my doctor.
As a patient who has had to use the ED, this is an interesting piece,- plus sound advice..Thanx.
As another patient who was brought by ambulance to the ED (and then spent a week in the hospital) and had a drunk in the bed on the other side of the curtain in the ED, this was a very interesting piece for me as well.
When my doctor tells me I need to go to the ER I refuse as the wait is awful and with my health issues I am exposed to virus that could be treated elsewhere
I am very interested in learning more about a possible initiative to educate the public relative to appropriate places to seek out health advice/care.
I am an Emergency Dept nurse and I feel that a lot of the decision comes from years of patients NOT knowing what the Emergency Dept is vs. Urgent Care vs. Primary Care. I think there was a certain period of time where we were too busy seeing patients, no matter what and trying to comply with EMTALA rules. We are also afraid of offending the public by attempting to teach them what is appropriate in regards to ED-UCC-PCP.
Thirty years ago a person’s insurance company would not pay for an emergency dept unless it was deemed an emergency. Something does need to change and I think those at the forefront of medicine could and should be the ones to step forward and lead the change.
Monica, right on! Everyone is just trying to do the right thing. We hope that making patients aware of appropriate places to receive needed care outside the ED, expanding our primary care access hours, adding electronic visits as an option for care, and addressing patient concerns more effectively, we will have better healthcare for everyone and less inappropriate use.
Thanks, Terri, for your thoughtful comment! 🙂
I think Spectrum Health Now is an amazing idea. I’ve always heard of it but I have yet to try it. Usually I see my PCP or go to the urgent care, but seeing as it is the cheapest option that might actually be my first choices
Hi Robert – Spectrum Health Now rocks. I’ve used it a few times, and my husband once. It’s so convenient and less expensive than going to our primary doc. Hope you enjoy it, too, Robert!
What is Spectrum Health Now and how does it work with Priority Health Insurance?
Hi Diane – Spectrum Health Now is essentially an online visit with a nurse practitioner, physician assistant or doctor that occurs through your cell phone or computer. It is similar to a regular doctor’s appointment except you don’t have to go into their office. You can schedule one in minutes by calling 844.322.7374. A video visits cost no more than $45 and may be fully covered by your insurance plan. As long as you are physically located in Michigan, you can take advantage of Spectrum Health Now for many of your health care needs – flu and cold symptoms among them. For more information on Spectrum Health Now, visit the website at http://mednow.spectrumhealth.org/. Best of luck to you!
We winter in Gulf Shores AL and for me there aren’t many options. Why can’t I use this service out of state. As a Priority Health insurer, down here they think I’m from a third world country.
Hi Dave, Sure do wish those out of state could use Spectrum Health Now. It has to do with physician and provider licensure – they’re able to treat patients in this state. I think it’s something they’re working on, though. So maybe in the future. Best wishes to you in Alabama. We’ll think of you from a very cold, very snowy Michigan. Cheers, Cheryl and the Health Beat team
If I live in Michigan but am vacationing in Orlando, can I use the service?
Hi Betty! Lucky you – you’re in the sunshine of Florida? 🙂 Unfortunately at this time, only those who are physically located in Michigan at the time of service may use Spectrum Health Now. Here is a list of urgent care clinics I found in the Orlando area – https://www.yelp.com/search?cflt=urgent_care&find_loc=Orlando%2C+FL … hopefully you get to feeling better! We’ll be thinking of you from cold, snowy Michigan. Best, Cheryl
This sounds interesting, but how can a dr. examine you on a camera. What if the patient may have an ear infection or Strep etc… don’t you need to be seen in person?
Hi Rita – I can only speak for myself, but when I had a sinus infection, I used Spectrum Health Now, and they were able to look through the camera in my phone (and a flashlight I had handy) to see the back of my throat via video conferencing. My husband had a rash on his back, and we showed the rash through the phone camera as well. It worked great for us. Best, Cheryl