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With ‘virtual ER,’ Elliot Hospital hopes to cut patient wait times

A doctor looks at a screen, where a woman is displayed gesturing toward her throat.
Dr. Kevin Rankins, a physician in Elliot Hospital's emergency department, demonstrates a virtual appointment.

With New Hampshire emergency departments filling up, one hospital is trying to reduce wait times by offering a virtual option.

Elliot Hospital in Manchester launched a Virtual ER service at the beginning of this year. It’s staffed by physicians who can see patients remotely, order a test or X-ray, and refer them to urgent care or the actual emergency department if needed.

Chief Medical Officer Kevin Desrosiers said people show up to the ER with all kinds of ailments. While doctors prioritize the most serious cases, like heart attacks and life-threatening injuries, someone with respiratory symptoms or a broken foot may have to wait for hours.

“We're really relying on patients to be able to self-triage as to what condition they have and then what level of care they need,” he said. “And we realized that that can be very complex for patients.”

Desrosiers said the Virtual ER is trying to solve that problem. People experiencing medical emergencies should still head to the emergency department, he said. But for less urgent issues, a physician may be able to handle it virtually or refer a patient to the appropriate location for care – potentially sparing them an unnecessary wait in the ER.

For example, someone with a cut could have a doctor look at it via video, to determine the next steps.

“Is that going to need stitches? Is it going to need a washout? Is it going to need a surgery?” Desrosiers said. “You know, those are some of the questions that the virtual emergency room could sort out.”

Around 350 patients had used the service as of last week. Desrosiers said a lot of those have been respiratory illnesses – it’s that time of year – along with things like gastrointestinal complaints and urinary tract infections.

Most of those patients were able to complete their care virtually, with about 20% referred to a higher level of care. Desrosiers said that number could change as people become more comfortable using virtual care for a range of conditions. He suspects many patients are testing it out with more minor issues.

The virtual ER service is currently open weekdays from 10 a.m. to 6 p.m. Patients can log onto their MyChart online portal to book a time.

In recent weeks, hospitals in New Hampshire have said their emergency departments are extremely busy and warned that could lead to longer waits for less urgent conditions. The New Hampshire Hospital Association says that’s due to a combination of seasonal respiratory viruses, workforce shortages and difficulty discharging to backed-up long-term care facilities, on top of already high demand for health care.

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Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at
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