Does Telemedicine Reduce Emergency Room Congestion? Evidence from New York State

Overcrowding in emergency rooms (ERs) is a common yet nagging problem. It not only is costly for hospitals but also compromises care quality and patient experience. Our paper provides solid evidence that telemedicine can significantly improve ER care delivery, especially in the presence of demand and supply fluctuations. We believe such findings are critical for ERs, due to the special setting of unscheduled arrivals leading to high unpredictability of patient traffic. Additional evidence suggests that the efficiency gained from telemedicine does not come at the expense of lower care quality or higher medical expenditure, which points to telemedicine as a feasible solution to the ER overcrowding problem. For healthcare practitioners, our paper highlights the general applicability of telemedicine through the “hub and spoke” architecture. Besides increasing patients’ access to more immediate care from specialists who were not available otherwise, telemedicine enables flexible resource allocation for any hospitals, regardless of where hospitals are located. Our research also provides ground for policymakers to incentivize hospitals to adopt telemedicine in ER, which we believe is critical given the relatively low adoption rate, the lack of direct evidence on its effectiveness, and the current inflexibility of reimbursement policies regarding the application of ER telemedicine. Overcrowding in emergency rooms (ERs) is a common yet nagging problem. It not only is costly for hospitals but also compromises care quality and patient experience. Hence, finding effective ways to improve ER care delivery is of great importance. Using a large data set covering all emergency visits in New York State from 2010 to 2014, we investigate whether telemedicine enhances ER care delivery. We show that, on average, telemedicine availability in the ER significantly reduces average patients’ length of stay (LOS), which is partially driven by the flexible resource allocation. Specifically, the adoption of telemedicine leads to a larger reduction in ER LOS when there is a demand surge or supply shortage. Furthermore, such improvement is not a by-product of other widely adopted health IT applications and does not come at the expense of care quality or patient cost. We also replicate the analysis using annual U.S. hospital data and find that ER telemedicine adoption significantly reduces average patients’ waiting time, which suggests that the LOS reduction partially comes from the redu