Emergency Department innovation at MUSC Health gets results and expands

A pilot program aimed at improving patients’ experiences in two Emergency Departments in Charleston has been such a success that it’s expanding to three other MUSC Health hospitals in Orangeburg, Florence and Marion

The results are remarkable, said Marc Bartman, M.D., and Danny Park, M.D., the emergency medicine doctors leading the effort. Their program cut “door-to-provider time” in half, referring to how long it takes for patients to have a chance to talk with doctors. They also reduced the number of people who left the Emergency Departments without seeing a provider by 80%.

“We have an opportunity to reimagine emergency care,” said Park. “For the past 20 years, the ED care model has barely changed. We’re bringing innovation into the space to create a more patient-centered experience from the moment a patient walks through our doors.”

Virtual Provider in Triage, or VPIT

The initiative is called Virtual Provider in Triage, or VPIT. It uses telehealth to connect patients with doctors soon after they arrive in the hospital. They talk one-on-one in private consultation spaces.

Patients with simple needs, such as medication refills, can be helped without having to wait to see a doctor in person. For people who need more in-depth care, the virtual consultation can lead to earlier imaging and testing.

 

But Bartman and Park emphasized that the telehealth visit does not replace in-person care for people who need it. Instead, it jump-starts the process and shortens wait times, ensuring that patients are seen and heard earlier.

Improving the process

Bartman said their innovation began with rethinking the first steps of emergency care. “We decoupled the traditional triage process.”

In many Emergency Departments, triage nurses ask initial screening questions, with physicians occasionally on hand to add comments or make decisions.

“But these moments can be rushed and confusing for patients,” Park said. “Often, patients don't even realize they've spoken to a provider. We want to make sure that the patient has a chance to talk one-on-one with the provider.”

So MUSC Health created a streamlined and more personal process. “It’s paying off,” Bartman said. “We've increased the efficiency of how quickly we're seeing patients, and we've significantly improved the patient experience.”

Follow-up care

And now, the Emergency Department telehealth program is growing in scope. “As part of their discharge plan, select patients will be scheduled for a virtual follow-up visit with one of our providers. This brief check-in allows us to reassess their condition, address any new or ongoing concerns and prescribe medications if needed,” Bartman said. 

“It also helps determine whether continued recovery at home is appropriate or if further evaluation is necessary. This added layer of support ensures safer transitions and helps prevent unnecessary return visits to the ED.”

The impact of the Virtual Provider in Triage program is gaining national attention. Park and Bartman have presented their model to audiences across the country, and several hospital systems have reached out for guidance on implementation.

“It is an opportunity for us to change the status quo and move the field forward,” Park said. “We’re not merely improving metrics and outcomes. We’re redesigning what emergency care can look like.”