ED wait times: There’s an app for that

In Editorial by Edmund Kwok8 Comments

wait timesThe Winnipeg Regional Health Authority recently announced the availability of a new smartphone app called Connected Care which allows users to view up-to-date information on ED wait times at the various hospitals in the area. It is free to download, and the link to the Apple App Store can be found here.

I decided to download it and take it for a spin.

The actual app description claims that the purpose of the app is to allow users to “find health services (hospitals, programs and organizations) in Winnipeg” with the ability to look up current ER wait times of local hospitals as part of its overall functionality. If you read the fine print, the app reports “the approximate times people are currently waiting before being placed into a treatment area“… not the time to see a physician. The app also provides a nice little map with distances to each center, which I assume is meant to help guide those patients healthy enough to walk/drive/bus/etc in formulating their transportation plans to the ED of their choice.

ED Wait Times: Do they matter?

Of note, the app contains a warning/disclaimer pop-up which states “Even if the wait times appear long, you will be seen quickly if your condition is an emergency. If your condition is life-threatening, please call 911 or go to your nearest Emergency Department immediately.”:

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Hmm, so let me get this straight. As a patient, if I think I’m having an emergency condition (i.e. emergent enough to want to go to an ’emergency’ room) I should ignore the posted wait times because I’d likely be seen quicker. If I think it’s life-threatening, I should forget using the app with its wait times information and location services altogether. Of course, this assumes that I know what’s an ’emergency’ and ‘life-threatening’. Got it.

Who is the app for?

Publishing ED what times is not a new phenomenon, and some of the potential problems with it have been discussed previously. What’s really intriguing to me are the questions: Who is this app meant for? And what is it trying to accomplish?

From the patients’ perspective, it is not clear that this app (or similar offerings via websites from other health regions) provides the information they want: the time to see a physician. Providing a single average and max time (is there a money back guarantee?) to being placed in a treatment area is misleading as this depends on an individual patient’s chief complaint and condition. The pop up warning suggests there is a need for accurate self-triage before patients can use the app safely. As a patient, I think I would much rather have an individualized waiting time estimate to see a physician after being triaged – but that’s just me. Unfortunately, there has not been any published literature to explore what wait times information patients themselves actually want published.

From the healthcare providers’ perspective, it is tempting to believe that this app may divert unnecessary ER visits (e.g. when patients can see from home that wait times are long) or at least redistribute volume more evenly across different hospitals. After all, Winnipeg has recently been making the news for the worst ER wait times in Canada. However, there is the potential that this will also cause stoic patients with true emergencies to stay at home to avoid the wait. Additionally, the flip-side (with the app encouraging more unnecessary ER visits when patients see that the local ER wait times are low) is equally plausible.

What do you think? Are apps like this one useful? What unintended consequences do we need to watch out for?

 

Edmund Kwok

Edmund Kwok

Emergency Medicine. Quality Improvement. Patient Safety. Change Management. Healthcare Administration.

Frontdoor 2 Healthcare

Frontdoor2Healthcare, founded by Dr. Edmund Kwok in 2012, provides editorial and commentary on issues affecting Canadian healthcare from the emergency department’s “front door” perspective. Frontdoor posts allow for open sharing of the diverse opinions and perspectives of emergency physicians from across the country.

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