Editor's note: This article was edited to appear in the print edition of Modern Healthcare. Experience the multimedia version of this special report.
Dwayne Grayman needed his stitches removed four days after having a severe facial laceration sewn up in New York-Presbyterian/Weill Cornell Medical Center's emergency room.
Grayman, 60, returned to the ER on the Upper East Side of Manhattan for the procedure. But instead of waiting hours for a physician, he was ushered into a private room where a physician assistant removed the stitches.
New York-Presbyterian requires that all patients in some of its hospitals—including the one where Grayman was treated—be seen by an attending physician. And Grayson was. After the PA removed the sutures, a physician saw Grayman via a video-conference hook-up in the room.
Less than 20 minutes after he arrived, Grayman, who works with kids at a community organization, was out the door. “It was quick,” Grayman said. “I'd absolutely do it again.”
Grayman was a patient of Emergency Department Express Care, a new component of New York-Presbyterian's emergency-room care. Express Care virtual visits take place within the emergency department in private rooms with comfortable chairs and video-conferencing screens. They're available 16 hours a day, seven days a week.
Estimates of the portion of visits to the ER for non-urgent conditions vary wildly. One meta-analysis put the number at about a third. Virtual visits are one way for hospitals to more efficiently deal with those patients.
Here's how it works. First, a nurse takes the patient's vital signs. Then, a physician's assistant or nurse practitioner does a medical screening and determines if a video visit would be suitable.
If it is, and the patient agrees, he or she is brought into a private room to video-conference with a doctor located somewhere else in the hospital. When the visit is over, discharge papers are printed right in the room, and the patient is free to leave. An entire visit, from arrival to discharge, takes about a half hour—just a fraction of the usual hours-long wait.
Since the $4.8 billion academic medical center launched the program in July 2016, the response has been resoundingly positive, said Dr. Rahul Sharma, the emergency physician-in-chief for New York-Presbyterian/Weill Cornell Medical Center. Patient- satisfaction scores are in the 99th percentile.
“It was a pleasant experience,” Grayman said. “The three of us were in tune to what was happening.” That kind of personal conversation is one of the reasons patients like Express Care, said Dr. Peter Fleischut, New York-Presbyterian's chief innovation officer. “I thought technology may interfere with the physician provider-patient relationship,” he said, “but it actually enhanced it.”