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The Latest In Medical Convenience: ER Appointments

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"When is the last time someone bought plane tickets at the gate?" he said.

UCSF Medical Center started using InQuicker in its emergency department in 2012 and expanded it a year later to its acute care clinic, where less-critical cases are handled on a same-day, walk-in basis. Now the system is also being used to book primary care appointments.

Under the former way of doing things, Eva Turner, assistant director of ambulatory services for UCSF's primary care department, said patients were often frustrated because they had no way of knowing in advance if same-day acute-care appointments were still available. "Before (InQuicker), patients would park their car, pay the garage fee only to find out we can't see them," she said.

Critics weigh costs

Some critics say the online check-in system may be convenient but is not necessarily cost-effective. It could encourage patients to seek care in the costliest of settings, emergency rooms, when they should be going to less-expensive urgent care centers or medical offices, they say.

If the country wants to decrease health care costs, patients need to be treated at the right place at the right time, said Del Morris, president of the California Academy of Family Physicians. Patients who can make appointments should do so at their doctors' offices, he said.

"This sounds like it is the most expensive place," said Morris, medical director of the Stanislaus County Health Services Agency. "Emergency rooms are there to take care of people who have emergencies."

San Ramon Regional Medical Center began using InQuicker in 2012 and sees about 33 patients a month through the service. Most are people who have sore throats, ear aches and stomach pains, said Sue Micheletti, the hospital's chief operating officer.

On the Web page where patients can select their time slot, they are given the option of looking for somewhere else for care: "Not an Emergency? Locate an Urgent Care Center near you."

Patients appreciate the convenience of knowing approximately when they will be seen - and avoiding the emergency room crunch times, she said. "That is worth a lot to them," she said. "When it rains, it pours. Our emergency room sometimes gets slammed."

Loma Linda University Medical Center in San Bernardino County, however, stopped using InQuicker after too many patients who hadn't made the appointments complained that others were walking in the door and being seen ahead of them.

The emergency room physicians liked it, but the nurses got tired of dealing with frustrated patients, said Kathleen Clem, chairwoman of the emergency medicine department.

Under the Affordable Care Act, however, Medicare reimbursements for hospitals are tied to results on patient surveys.

Dignity Health, which is also offering the online reservations at urgent care centers and doctors' offices, hopes that the new service will boost those patient satisfaction scores at the same time it minimizes wait times, said chief nursing officer, Page West.

Wed, Jul 02 2014

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