Innovative Health Technologies to Improve Emergency Department Performance

Abstract

Background Emergency Departments (EDs) are increasingly pivotal, with a constant increment in their use, despite stable or declining fundings. Crowding can lead to disruptions and the COVID-19 epidemic has further burdened ED services. However, the pandemic has seen an increased use of telemedicine and digital health tools, which may be notably beneficial for EDs. This study offers a review of the latest available digital health technologies and their effectiveness to improve ED performance. Methods We performed a narrative review to identify digital and technological innovations in EDs. The themes of interest were defined in 4 areas: Patient Assessment, Patient Experience, Resource Allocation, and Discharge. Data was analyzed by 5 independent reviewers who focused on different macro-areas. Disagreement on data was discussed with 2 independent tiebreakers. Results Our search yielded 25 articles addressing 4 topics: Patient Assessment, Resource Allocation, Patient Experience, Discharge. We found that digital tools and Artificial Intelligence are powerful tools to detect, collect, and process data from patients, to improve healthcare delivery in EDs. The Resource Allocation category showed to be key in optimizing services already in place. New technologies showed effective to improve Patient Experience by curbing pain and anxiety. Innovative technologies demonstrated efficacy after Discharge when patients need guidance from clinicians for follow-up care. Conclusions Our review shows evidence of increasing effectiveness of innovative tools in reducing wait time and improving performance and patient experience in EDs. Technology applied to resource allocation appeared to be the most effective category. Prediction algorithms could be used to improve workforce allocation and bed management. Critical care systems must meet the challenge of innovative technologies which can lead to a new era in healthcare delivery with improvements for patients and healthcare professionals. Key messages • Digital innovation will have a significant impact on several dimensions of healthcare in the near future. • Healthcare systems and EDs must meet the challenge of innovative technologies which can lead to a new era in healthcare delivery with improvements for both patients and healthcare professionals.

Digitalization in the Emergency Department—An Interview Study of Nurses’ Experiences in Norway

“…To them, this represented increased patient safety. This positive effect of digitalization in the ED has been underlined in several previous studies [6][7][8]15]. However, few of these studies were based on the perspectives of ED nurses and beyond specific digital tools, such as wearable sensors or handheld computers.…”

“…An interview guide was developed based on previous research on digitalization in the ED [6] and several discussions between all the authors (see Box 1 below). Which equipment or tools do you associate with "digital" in your work?…”

“…A 2022 literature review, including 25 articles, explored the available digital health technologies and their effectiveness in improving performance within this complex ED context [ 6 ]. The results indicated that digital tools and artificial intelligence were useful to detect, collect, and process data from patients.…”

“…Previous studies have provided an overview of available technologies in the ED [ 6 ], and explored the effects of wearable tracking devices [ 7 ] or handheld computer devices [ 8 ]. Studies exploring ED nurses’ perspectives are limited to focusing on iPhones [ 14 ] and EHRs [ 15 ].…”

The development and validation of a novel deep-learning algorithm to predict in-hospital cardiac arrest in ED-ICU (emergency department-based intensive care units): a single center retrospective cohort study

“…While the output represents a commonly cited reason for crowding in EDs [7,8] during the COVID-19 pandemic, this challenge has been highlighted due to limited access block and the transmissibility of the coronavirus, thus leading to a dose-response increase in the rate of mortality in patients in the ED [9][10][11]. Novel strategies have been implemented to overcome this situation such as innovations in telemedicine, airway management using video laryngoscopes or infection control [12,13]. Meanwhile, Emergency Department-based Intensive Care Units (ED-ICU) has been proposed to optimize the delivery of critical care and alleviate the crowding burden in EDs in contrast to conventional ICU admission systems [5,14].…”