Next time you go to an emergency room, take a close look at the person to your left, then the person on your right.

There’s a good chance one of them doesn’t belong.

In theory, about half of all emergency room visits could be handled someplace other than the emergency room, according to Theresa Osborne, MD, medical director for Spectrum Health Medical Group.

And that’s especially the case during the cold and flu season.

“Emergency departments are set up to deal with trauma, life-threatening illnesses, things like that,” Dr. Osborne said.

That’s not to say emergency room workers can’t handle the hordes of care-seekers who trundle through their doors. They can and they do, every day.

But in about 50% of cases, emergency room patients could receive more appropriate and affordable care elsewhere.

Primary, urgent or video visit?

Urgent care and primary care practices are frequently suggested as those better places to receive care for non-emergent situations.

A call to your doctor might get you in for a quick visit same or next day, and visiting an urgent care center will result in care within a couple of hours.

But in light of the recent surge in flu cases, medical experts in Michigan are now encouraging people with symptoms of cold or flu to stay home and seek immediate care through Spectrum Health app video visits.

“Technology has allowed us to bring care to you,” said Joseph Brennan, one of the creators of Spectrum Health virtual care. “For conditions like the flu, don’t bundle up and drive somewhere, don’t pack up all of the kids, don’t sit in a waiting room, and don’t risk getting something else from someone else. Stay home. Stay in bed. Receive the care you need where you are and when you need it.”

Spectrum Health offers 24/7 on-demand video visits through people’s cell phones or computers from the convenience of their homes, dorm rooms, or wherever they find themselves.

It’s as easy as downloading the Spectrum Health app to make an appointment with a Spectrum Health provider. Wait times average 15 minutes.

Amanda Reed, director of operations from Spectrum Health virtual health, said patients often report they appreciate the convenience. Many are initially a bit hesitant about using the service.

“But after the first experience, we receive feedback about how well their video visit went and what a great experience they had,” she said.

Anyone in Michigan may receive care through the Spectrum Health app. The caller does not have to be a Spectrum Health patient.

“They could be traveling here or visiting family,” Reed said. “As long as you are physically in the state of Michigan, you can use (the service).”

Many Spectrum Health patients choose not to make the video call right away. They prefer to schedule it at a convenient time—during their lunch hour or at the end of the day, for example.

“Patients are really excited and really engaging,” she said.

Trending up

Overuse of the emergency department is “high, very high,” Dr. Osborne said.

Spectrum Health’s emergency departments log about 250,000 visits per year, the majority of them at the Michigan Street emergency rooms in Grand Rapids. About 48% of all these visits were possibly avoidable.

“Our numbers are trending up,” Dr. Osborne said. This meshes with American College of Emergency Physicians poll results that indicate emergency visits have increased in the U.S.

“This country is currently relying on the emergency department to meet the need for acute, unscheduled care,” she said. “It’s really disconcerting to a lot of folks. It’s driving up the cost, a lot, for everybody.”

The cost issue is, of course, overshadowed by the need to provide patients with proper medical care in the proper settings, Dr. Osborne said.

“We’re not just trying to reduce use—we want to improve outcomes,” she said.

The average cost of an emergency room visit is more than $1,000; a primary care visit is about $70 to $150; and a Spectrum Health video visit is $45. If Spectrum Health providers ultimately refers a patient elsewhere for care, the video visit is free.

“Clearly, an emergency room visit is much, much more expensive,” she said.

Still, some patients will choose the emergency room as a first option for minor issues because they have no other place to go–no primary care doctor, or perhaps they’re unfamiliar with urgent care.

“A large majority think they have to go to ER right now, for whatever reason,” Dr. Osborne said. “Emergency or not, this is the only place open.”

There are obvious reasons for speeding off to the emergency room, certainly when life or limb is at risk or when the outcome could threaten disfigurement or long-term consequence.

Beyond that, it’s not always so evident.

“We have many options to receive needed medical care, other than the emergency department,” Dr. Osborne said.