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And Rosenau of the American College of Emergency Physicians says many hospitals using digital records meet regularly to discuss possible glitches and to make recommendations to vendors on ways to make programs more helpful for doctors. “Hope you like being prodded and probed.” It’s no surprise that a visit to the emergency room isn’t cheap, but bills are often inflated by tests and procedures some doctors say aren’t really needed.Sometimes the tests are requested by overly cautious patients, but often, they are added by doctors making sure they’re covered if they end up in court.Some hospitals stop the clock at the point when a patient is first greeted, others when a patient is first examined and others when a patient is moved to a room, ACEP points out in its report.And unusually high wait times can occur with little or no notice, doctors say, rending predicted waits inaccurate.Meanwhile, the number of emergency departments is down about 11% over that same time period.

Many hospitals measure wait times differently, making it difficult for patients to interpret them.“I could advertise my wait time as 20 minutes but then a school bus of children comes in and it’s now an hour and a half,” says Rosenau. “Our riskiest procedure doesn’t involve needles or scalpels.” Some doctors say the most dangerous procedure that happens in the emergency room doesn’t take place anywhere near the operating table: It’s the handoff that happens between doctors and nurses changing shifts or when patients are transferred to another department.If doctors don’t communicate well when they’re changing shifts, insiders say, the most important information about the patient can get lost amid the list of figures and status updates in the patient’s chart, making it difficult for the doctor taking on the patient to know what to prioritize.And lowering wait times could also protect their bottom lines: Because of a pay-for-performance system created by the Affordable Care Act, Medicare payments to hospitals are partly based on patient satisfaction. For instance, if hospitals interrupt care in an effort to move some less-urgent patients through the system, they may be putting high-risk patients in danger, according to an informational paper on wait times by ACEP.And patients who avoid the emergency room because they’re worried about long wait times could be putting themselves at risk, doctors say.Another common concern among health pros is that the time doctors spend entering and scanning medical records takes away from time that could be spent with a patient.