New trend pressures clinical pathology laboratories to shorten turnaround times for key lab tests
Anyone who says there’s not much competition for patients has ignored the marketing battle among hospitals to attract patients to their emergency departments (EDs). In a growing number of cities, major hospitals now aggressively advertise guarantees of ever-shorter wait times in their EDs. This trend has a direct impact on clinical pathology laboratories because they must improve turnaround time (TAT) on lab test results to support faster patient care in EDs.
Using the promise of faster patient access to a doctor in the ED is a fascinating phenomenon. It shows that patients do recognize the difference in service they get from hospitals in their community. (Note to our pathology and laboratory friends in the United Kingdom, where lengthy patient wait times are often an issue: here’s an example of how America’s patients’ desire for better faster access to medical care can provide competitive advantage to the American hospital that provides such access.)
Patient Care Trend that Touches Clinical Laboratories
The power of this trend surrounds us. In city after city across the nation, hospitals are engaged in highly visible advertising campaigns that tout the short wait times to see a physician in their emergency room. Some hospitals advertise wait times on billboards. Many use their websites to provide real time updates on ED wait times.
Back in 2004, Detroit Medical Center in Detroit, Michigan, was one of the first to use billboards to advertise shorter wait times in the emergency department (ED). Here is the billboard used by Henrico Doctor’s Hospital in Richmond, Virginia. Note the electronic screen, which shows the actual wait times. (Photo © McComb Daily.)
The most innovative hospitals developed apps (applications) for iPhones, Androids, and other Smartphones. These apps allow the hospitals to push out actual wait times to Smartphone users.
The goal is to increase transparency, reduce the load at high-traffic EDs, and improve patient care. It’s a bold experiment that is stretching hospital-based clinical laboratories to reduce the turnaround time for certain tests from an average of 60 minutes to an average of less than 15 minutes.
Reasons for posting wait times range from diverting traffic from overloaded EDs to increasing the profitability of outlying hospitals. But, it’s clear that consumer expectations continue to drive changes in the healthcare continuum.
In Kansas City, Missouri, the HCA Midwest Health System posts this definition on their website next to a running tally of wait times at the six hospitals and medical centers in the health system:
“The ER wait time represents the time it takes to see a qualified medical professional, defined as a Doctor of Medicine (MD), Doctor of Osteopathy (DO), Physician Assistant (PA) or Advanced Registered Nurse Practitioner (ARNP).
“ER wait times represent a four-hour rolling average updated every 30 minutes, and is defined as ‘the time of patient arrival until the time the patient is greeted by a qualified medical professional.’ Patients are triaged at arrival and are then seen by a qualified medical professional in priority order based on their presenting complaint and reason for visit.”
Adam Rudd, COO at Grand Strand Regional Medical Center, an HCA hospital in Myrtle Beach, South Carolina, believes keeping the public informed about advances in ED throughput is one of the best uses of ED wait time advertising. For example, HCA now gets lab test results and imaging studies to doctors faster and has reduced the time patients spend “boarding” in ED hallways. Their hard work resulted in a 40% decrease in patient ED wait times, which is improvement that Rudd wants communicated to the public via various marketing campaigns.
“We are trying to provide all of our customers and patients with as much information as possible to make decisions,” Rudd explained to Modern Healthcare in a November article, “and one key part of that is how long they have to wait if they come to one of our emergency rooms.”
“In all cases, if it’s an emergency situation, they need to go to the closest emergency room,” he added. “But if they can make a choice, we want them to make the best choice for them.”
HCA even provides a downloadable app for iPhones, Android, Palm, BlackBerry and other Web-enabled devices. It’s called iTriage and according to HCA’s website it “offers information on symptoms, diseases, medical procedures, urgent care facilities and other vital health-related searches to help consumers make more informed and immediate healthcare decisions. The leading-edge technology even provides turn-by-turn directions to an HCA Midwest facility for treatment. It too will give you instant access to our ER wait times.”
Hospitals are Competing for Patients
HCA hospitals, like many health systems in America, are taking proactive steps to distribute the load among its hospital EDs. They are providing patients with electronic tools to help accomplish that goal. There are, however, other reasons for advertising ED wait times. Competition, for example.
Also in Modern Healthcare, Linda Quick, President of the South Florida Hospital & Healthcare Association, an early adopter of ED wait time advertising, said that attracting the “right kind of patients” is the main reason to advertise ED wait times.
“They clearly want people who have resources to use their emergency department, versus someone else’s emergency department,” she said. “On the other hand, not so much do they want people to use them who don’t actually have an emergency service need, or who don’t have coverage or the wherewithal to pay.”
This indicates that many hospitals in America are actively pursuing transparency in healthcare as well as profit, and embracing technology that can accomplish both. The public seems ready for this healthcare paradigm.
For example, Detroit Medical Center also posted an iPhone app on their website that displays ED wait times at their six hospital EDs. Between May and November it was downloaded more than 1,000 times. They recently added an Android app as well.
Hospital-based clinical laboratory managers and pathologists should take a hard look at the technology now in place in their medical laboratories and ask themselves if they are prepared to interact with all areas of critical care delivery in a meaningful way and with modern technology. As the marketing battle around shorter ED wait times for patients demonstrates, competition continues to raise the bar for patient and consumer expectations.
Related Information:
Losing Some Wait (Modern Healthcare)
HCA billboards to post current ER wait times
See Detroit Medical Center’s web page with ER wait times at all health system laboratories:
Great article. iTriage has nearly 1 million mobile users and is helping patients all around the country find ER’s, ER wait times, urgent cares, and specific doctors. Everyday we get thousands of additional downloads and users, and we are consistently in the top ten of health apps, and often in the top 200 of all apps. Our featured listings, which allow hospitals and providers to share what they do well with the user, get 10 – 25 times the traffic of a basic facility or provider listing, and people use our system to take action and find care based on our information.
In areas around our hospital customers, we have a much higher penetration of users, and typically have quite a few more users than any hospital specific app has been able to achieve. Working with a national vendor like iTriage, in addition to any hospital specific technologies, makes a lot of sense for these reasons.
Thanks for your article,
Pete
Peter Hudson, MD
CEO, Healthagen
Developer of iTriage
New multiplexing technologies have been developed which if adopted by hospital labs, can greatly reduce this wait time for results.
For example, the cardiac biomarker H-FABP can predict long-term mortality in suspected ACS patients who are high sensitivity Troponin-Negative, and show elevated levels as early as 30 minutes after symptom onset – when used with the Randox Evidence Multistat biochip array technology analyzer. This machine can be placed in the emergency department, providing ‘near patient’ results which is an important factor in reducing time to patient diagnosis and treatment.