Telemedicine Improves Emergency Room Efficiency Interview with:

Susan Lu PhD Gerald Lyles Rising Star Associate Professor of Management Krannert School of Management Purdue University

Dr. Love you to the moon and back!

Susan Lu PhD
Gerald Lyles Rising Star Associate Professor of Management
Krannert School of Management
Purdue University What is the background for this study?

Response: We started this project in 2016. 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. Meanwhile, the advancement of healthcare technologies including electronic medical records, online doctor ratings and 4G mobile network motivates us to think about the impact of telemedicine on ER operations in the near future. What are the main findings?

The main findings are:

  • Increasing telemedicine availability in the Emergency Room (ER) significantly reduces the average patients’ hospital stay.
  • When using telemedicine and there is a demand surge or supply shortage ER hospital stays decrease more rapidly.
  • Using telemedicine to reduce a patient’s length of stay partially comes from the reduction of wait times.
  • Such improvement is not a byproduct of other widely adopted health IT applications and does not come at the expense of care quality or patient cost. What should readers take away from your report?

telemedicineResponse: Our paper shows that telemedicine achieves efficiency gain through potentially several channels. In addition to more efficient information exchange, telemedicine can greatly improve care delivery through flexible resource allocation, 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.

For healthcare decision-makers, our findings also have important implications. Due to the lack of evidence and the inflexibility of reimbursement policy, the adoption rate of ER telemedicine remains low and grows slowly. Our research provides ground for policymakers to incentivize hospitals to adopt telemedicine in ER. In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law to promote the adoption and meaningful use of health information technology. The policy provides financial incentives for digitizing records, which significantly facilitates the adoption of EMR and HIE. We believe that it is time for policymakers to incentivize ER telemedicine adoption as well. The recent introduction of HCPCS Code G2010 by the CMS to cover “remote evaluation of pre-recorded patient information” is a good example, but more coverages are needed. What recommendations do you have for future research as a result of this work?

Response: Previous literature points out the role of telemedicine in reducing the service divide between urban and rural areas through the “hub and spoke” architecture, where smaller “spoke” hospitals connect larger “hub” hospitals for consultation. Our paper highlights the general applicability of such a two-layer architecture for ER patients. Besides increasing patients’ access to more immediate care from specialists that were not available otherwise, telemedicine can help address demand shocks and supply shortages for any hospitals. With the continued advancement of information technology such as augmented reality and wearable devices, telemedicine can be the key to increase healthcare access and to improve the health care delivery efficiency, no matter where hospitals are located. Future research can focus on how technology advancement changes the healthcare delivery.


Sun, Shujing and Lu, Susan Feng and Rui, Huaxia, Does Telemedicine Reduce Emergency Room Congestion? Evidence from New York State (December 15, 2019). Available at SSRN: or


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Last Updated on October 23, 2020 by Marie Benz MD FAAD