- A new program in Washington D.C. has triage nurses helping 911 dispatchers field calls in an effort to divert non-emergency calls to urgent care centers and outpatient clinics while stemming wait times, cutting costs and improving patient outcomes.
- Nurses are also able to coordinate Lyft rides for Medicare recipients experiencing a non-emergency and to set up primary care appointments, cutting down on expensive ambulance rides and ER visits.
- The program is two years in the making, coordinated by the D.C. Fire and EMS Department and involving dozens of healthcare stakeholders across the city.
Washington D.C. has the highest rate of 911 calls in the country and a historically overburdened emergency medical system. The new program aims to address those issues while improving patient outcomes and reducing costs for insurers and the city. The program follows a recent successful effort to improve ambulance response times.
The city's nurse triage line is not the first of its kind. The concept of embedding triage nurses in dispatch centers originated in Europe and eventually made its way to Richmond, VA, in 2004, where it was met with some skepticism from residents and shuttered five years later. Louisville, KY, implemented a nurse triage line in 2010, followed by five other similar programs in jurisdictions across the country, including Fort Worth, Texas, Reno, NV, and, as of last year, Las Vegas.
A paper published in the Annals of Emergency Dispatch and Response in 2015 analyzed the cost avoidance of the Emergency Communication Nurse Systems in Fort Worth and Louisville and found nurse triage lines to be a "feasible solution for reducing patient costs, using resources more efficiently, and maintaining high levels of patient satisfaction."
That analysis combined 9 months of call data from MedStar in Fort Worth (304 patient records) and 34 months from the longer-running Louisville system (3,672 patient records) and found nearly $1.2 million in payments were avoided as a result of diverting patients from the emergency centers. The result was a combined savings of nearly $450,000 in costs and a patient satisfaction rate of 91.2%.
DC's program will also be a boon to private transportation services. Uber, which recently launched its healthcare transportation platform, has an existing partnership with MedStar in the district that allows healthcare workers to book rides on demand. A recent study found that ambulance use decreases by at least 7% when Uber enters a city.
Lyft is also steamrolling into the market through a number of partnerships. The ride-hailing service recently announced a partnership with Allscripts that will allow physicians to integrate non-emergency medical transportation into Allscripts' Sunrise EHR and a partnership with Acuity Link that expands NEMT options for hospitals.
D.C. plans to measure the success of its new program with a next-day follow-up survey for callers who are diverted to clinics.