Improving Patient Communication and Transparency in the ED

MedStar Washington Hospital Center’s ERAdvisor

Though the waiting room wasn’t overly crowded when I first arrived at about 11 p.m., there was a steady stream of people flowing back and forth through the doors to the treatment area. I could already sense that my visit would stretch into the early hours of Monday. Luckily, I had friends with me, but I didn’t want to burden them with staying too late.

When I first registered in a tablet device at the front desk, I was given the option of using my phone number for the hospital’s ERAdvisor, an ED journey tracking service that didn’t require a separate app to download but could be accessed securely through a web browser. With ERAdvisor, I could track my progress through the ED, view the results of tests and scans, receive estimated wait times from triage to discharge and even share my visit with my loved ones.

This was the first time I’d ever seen a service like this offered in an ED. Normally, without such an app, I’m sure I would’ve been bothering a nurse or other hospital staff members about what was next: When am I getting a CT scan? When will a doctor see me? When can I go home? But I didn’t have to ask that question even once because I could see it all in my ERAdvisor. Its user-friendly interface reminded me of the airline apps I’ve often used for traveling, offering relevant information that helped me better understand what was needed for my care.

Healthcare organizations that can streamline clinical and operational processes can not only improve staffing workflows but also patient satisfaction. As CDW healthcare strategists Mike Larsen and Jamie Lynn Ray write, “Ultimately, these efforts decrease manual processes, increase communication and coordination among care teams and enable organizations to deliver higher-quality care more efficiently. They can make a significant difference in alleviating clinician burnout and creating a better experience for patients.”

RELATED: How are healthcare organizations simplifying patient check-ins?

So, how did MedStar Washington Hospital Center get the idea to transform their ED operations and offer ERAdvisor to patients? Dr. Jennifer Thompson is an emergency physician and program lead for ERAdvisor at the hospital. She says that the solution came after years of trying other methods to improve communication, from physical pamphlets to an FAQ website.

“We see a high amount of ambulance traffic, we have a lot of highly complex workflows, and our team just really wants to care for patients. We learned that our team members were frequently being stopped to answer the same types of questions, so we thought there had to be a better way to make those answers more easily available to patients,” Thompson says. 

A multidisciplinary ED experience committee, which includes nursing leadership and representatives from the office of patient experience, helped to develop and improve ERAdvisor not only for patients but also for the team members, she adds.

“People are on their phones in the ER. It's an effective way to reach them, to provide some of those answers to commonly asked questions,” Thompson says. “It was a department-level initiative where our committee was brainstorming how can we best improve this aspect of care. Then we researched the options and brought it up to leadership.”

These kinds of initiatives are all part of MedStar Health’s ongoing digital transformation, improving access to patient care while also streamlining workflows for team members.

“If you’re a patient at our hospitals, we want to get you in the right place for the right care. We're focusing on transforming ourselves, and we want to take advantage of new technologies, such as artificial intelligence and other things, to make the care better,” says MedStar Health Senior Vice President and CIO Scott MacLean.

A Call to Change Emergency Department Processes

EDs are under a lot of strain, from long wait times and overcrowding to siloed workflows and lack of communication. After all, they’re an accessible “one-stop shop” for round-the-clock advanced diagnostics and treatment, as described by the research organization RAND. About 1 in 5 U.S. adults use the ED for care each year, and that number isn’t expected to decrease. In nearby Maryland, state lawmakers have even passed a bill to try to address ED wait times.

Evolving processes and implementing newer technologies have helped some healthcare organizations solve issues in the ED. AI-powered solutions at Richmond University Medical Center in New York and Children’s Hospital Los Angeles, for example, provide patients with projected wait times that offer more clarity for their ED stay. Illinois-based OSF HealthCare has a virtual ER service to reduce wait times so that qualifying patients can connect to a remote medical provider with a nurse or medical staff member in the room with them.

At MedStar Washington Hospital Center, Thompson has seen promising feedback from the use of ERAdvisor in the ED.

“About 75% of patients who give us valid cellphone numbers are using ERAdvisor in some way, which I consider a huge success,” she says. “When patients are waiting and they don’t know what’s happening, the frustration builds up, and that buildup can also be unleashed at times on team members. That affects team morale, particularly when their goal is trying to care for someone. So, I've noticed that, with ERAdvisor, that frustration tends to lessen as well. We’re constantly monitoring the tool, but we've had positive responses from both patients and our team so far.”

UP NEXT: Transform the emergency department with AI.

Thompson notes that, anecdotally, the quality of patients’ questions have changed since the advent of ERAdvisor. Because they can now track their ED visit down to a series of steps, patients can ask about specific aspects or results, helping to direct the focus of their care conversations.

“I have a patient who’s more informed, who feels like they know how to take care of themselves better when they leave, so that's another thing that has changed,” she says.

I felt that way when I was ready to leave the ED around 3 a.m. I knew that, thankfully, my X-rays and CT scans didn’t reveal anything alarming, and I had clear instructions on where to pick up my medication in the morning.

“When you start out with the patient at the center and add the people who are there every day in that environment, seeing what the challenges may be, and you start there for your solution, I think that's a good recipe for success,” Thompson says. “This is a groundbreaking MedStar Washington Hospital Center initiative that adds something to the patient experience that's different and that allows for more transparency, more patient-centered care and less stress during an anxious period where we care for people at their most vulnerable.”

I also spoke with MacLean to get an overview of the organization’s digital transformation journey.

HEALTHTECH: Can you share a timeline of MedStar Health’s digital transformation? What’s next?

MACLEAN: In the decade before 2020, we had adopted a common electronic health record for hospitals and clinics, so wherever you travel within our system, your record is the same. Pre-pandemic, we also were focused on access and digital tools, and how we might have better interactions with patients through the MedStar Health app. The next frontier at MedStar Institute for Innovation is looking at the acute care of the future. We have remote visual monitoring in our hospital rooms, where we can use AI-enabled cameras and software for fall prevention and things like that. We are working on virtual nursing models. Our focus is quality, safety and making sure that we're meeting our standard of care but also using enabling technologies to make things more efficient and, frankly, better and safer for everyone involved. Next, we're going to be making an EHR and revenue cycle migration to Epic. It's a journey we're going to make over the next couple of years. We're enthusiastic about it, and that will standardize us.

HEALTHTECH: How is MedStar Health managing expectations or communication between IT and clinical teams? What's effective in getting buy-in for other digital transformation projects?

MACLEAN: I would point back to our CEO, Kenneth Samet, who talks about “system-ness.” We have come together through some mergers and acquisitions, like other health systems, but he has always talked about us operating as a system, and everyone understands that from a leadership perspective. You should expect to see a consistent experience across our clinics and hospitals. There are technology interventions that we have to build into our EHR for screening and for order sets and treatment; you think about the IV fluid shortage last year. We're practiced at doing things differently at large scale, and the only way that you do that is that you have good strategy, leadership and execution.

HEALTHTECH: What are some healthcare IT priorities for 2026 for MedStar Health or the industry as a whole?

MACLEAN: I'm going to speak about that from my post as the board chair for the College of Healthcare Information Management Executives. There are many things that are at the top of the list, but I would go with interoperability. It's a term that's used a lot. We want to be efficient and safe in our care processes and not do repetitive testing. We want to be able to share appropriate data among clinicians and the people who are getting the care. I think the next thing is cybersecurity. We're all obviously very concerned about the privacy of our patient data. We take that very seriously, and we follow frameworks to be as vigilant as possible with defense, and so we talk about that as an industry and advocate for support. No one ever has enough resources for this, and it takes everyone to collaborate and cooperate, but particularly for rural and underserved areas, which need a lot of help.