“If I had 60 minutes to save the planet, I would spend 59 of them identifying the problem and one minute on the solution.”
That quote by Albert Einstein is applicable to many industries these days — and certainly applies to the world of healthcare. A fundamental business principle that healthcare so often gets wrong is putting the focus on the solution before identifying the actual problem.
By focusing on the end solution, we often miss the mark and the result of that is opportunities missed and resources wasted; the best-case scenario would only result in a slightly better version of something that already existed or even worse ... a solution that has no idea of its problem.
Part of it is our human nature. We create solutions because, quite frankly, it’s easier to just have an answer. Coming up with solutions or ideas are dramatically easier than truly defining the specific issue, or more importantly, the addressable problem. Looking for the ‘why’ isn’t always easy, and coming up with too many solutions doesn’t mean the problem is solved.
Where are the problems in Healthcare? And how do we find the solutions?
Allow me a moment here: Most of the overarching solutions in healthcare aren’t hard to find because it involves two of the most important, visible factors in the business of healthcare: the people and the process. But the people aren’t the problem; when we have the right people, they are the solution. It’s the process — healthcare is all too often doing it wrong, especially when it comes to emergency medicine and triage.
Examples of this are everywhere in our industry and it’s no surprise that problems have compounded, and now it’s too complicated to untangle it all to identify the deeper problems that exist. That’s where the idea of a Band-Aid solution seems the easiest. But that doesn’t mean it’s the right solution.
Virtual ER: Understanding the problem led to the right solution
My expertise and insight comes from my emergency medicine experience — both in the physical ER and as co-founder and CEO of UCM’s Virtual ER; therefore, it serves as my point of reference.
For decades, most ERs have built emergency medicine triage solutions around standard protocols to decide basic level of severity followed by initial diagnosis, treatment and next steps. Emergency Medicine triage itself doesn’t need to be solved, what needs to be solved is the process of triage. Making Emergency Medicine triage more effective is not a question of how – it is a question of where.
When Emergency Medicine triage is limited to taking place solely in the physical ER, we push patients through those emergency room doors, whether they need to be there or not. This leads to dangerously long waits due to overcrowding, staffing limitations and a host of other delays, there’s a good chance they will be informed that their condition was not deemed severe enough to require treatment within those four frantic walls.
Every 10 minutes a critical ER patient waits, it is estimated that their hospital cost of care increases 6%.
Adding to the problem: conditions that do not require emergency treatment actually end up being treated in the ER. The results of that end solution are again disastrous: needless costs, taking up beds, using ER staff for non-emergency needs, and ultimately, reduced quality of care for those patients who truly need immediate trauma and emergency care.
The solution lies in the process
Deciding the what, where and when of the patient’s specific medical needs does not always need to happen in the physical ER. Taking the pressure of Emergency Medicine triage out of the ER addresses the problem and creates the solution: the Virtual ER.
Emergency Medicine triage requires an Emergency Medical Provider to assess and diagnose and direct a patient to the most appropriate care. UCM’s Virtual ER applies Emergency Medicine Triage in conjunction with EMS and 911 to bring the ER to the patient (read our blog on this topic) and make sure patients only end up in the physical ER when absolutely necessary. The practical need of diagnosing, treating and triaging patients before they get to the ER ensures that patients get the right care, at the right place, at the right time.
That’s key to us at United Concierge Medicine and we believe this process will dramatically improve the way the physical ER functions and ultimately provides patient care with increased efficiencies , reduced wait times, lower costs, and focusing appropriate care right from the moment of the first assessment — that's Emergency Medicine triage!
I’m interested to hear your feedback. Find me on LinkedIn and let’s continue this conversation. Are there other problems within emergency care where you can see Virtual ER as the solution?
Keith Algozzine, PA - C is a board certified Physician Assistant and co-founder and CEO of United Concierge Medicine and Management (UCM). He believes in the idea that the Virtual ER will change the way emergency healthcare is delivered. A passionate advocate for change in the emergency medicine, he is committed to ensuring patients receive the right care, at the right time — when and where they need it most. He authors a monthly blog on topics related to virtual emergency medicine and the innovations around telemedicine that are changing the way healthcare works.