24/7 Advice From Nurses Reduces Emergency Room Visits in Wyoming

Emergency rooms in rural areas are a different animal than their urban counterparts: serious illnesses and injuries happen less often, but when they happen, specialists tend to be far away.

According to a new study, linking in pediatric critical care specialists by videoconference could help prevent errors treating sick and injured kids.

In rural ERs, generalist doctors made medication errors with kids, administering the wrong drug or the wrong dose of a drug, about 13 percent of the time when they didn’t consult with a specialist, according to the study.

When they called a specialist on the phone, the error rate dropped to 11 percent, and with videoconferencing dropped to 3 percent.

“We know that we make a difference by being able to see the patient,” senior author Dr. James Marcin told Reuters.

“It’s the difference between the doctor coming in to do an office visit with you with his or her eyes closed, versus with his or her eyes open,” Marcin said, comparing telemedicine to a phone consultation.


Some states, like Wyoming, are already trying out rural telemedicine programs, even linking doctors to patients before they get to the ER. In addition to reducing medication errors, telemedicine can reduce overall ER visits. Here, Nurse Jennie Echols introduces us to the system making a difference in Wyoming:

“Imagine this: It’s Thursday night at 10 p.m., and you’ve been experiencing nausea and dizziness for an hour. As a Medicaid patient, you’re not sure what your options are. Should you wait until the morning, or should you head to the emergency room?

Xerox and Wyoming Medicaid, part of the Wyoming Department of Health, are working together to help answer that question. Medicaid members can call the Xerox “24/7 Nurseline” at any time – day or night – to help them determine if they need to go to the ER. Xerox also analyzes data to identify individual patients who were going to the ER more than 10 times per year and help put preventive measures in place. These efforts improve quality of care and outcomes while ensuring members receive care in a healthcare setting best suited to their level of need and reducing costs for the state program thanks to fewer ER visits.

This shift from Medicaid as healthcare-financing program to healthcare-delivery system is among the conversations I had with my colleagues at this year’s Medicaid Enterprise Systems Conference. This meeting of the Medicaid minds is where state healthcare business and technology leaders gather to share ideas and re-imagine solutions for serving the health needs of millions. Xerox and the state of Wyoming participated in a session focused on using data analytics to improve quality of care.

In addition to using data to help Medicaid members make smarter choices about the healthcare facilities they visit, we’re helping Wyoming tap into data that is already available for its Medicaid members via electronic health records. When doctors and nurses have up-to-date information on lab results, ER visits and medication prescriptions, they can provide better quality care.

In an effort to focus on quality of care, Wyoming’s innovations set an example for all states, especially as many modernize their Medicaid technology platforms and seek to keep up with the rapid evolution in our healthcare environment.”…