Digital health tools, like patient portals, electronic health records (EHRs), telehealth, and AI systems, aim to lower healthcare costs, improve access, and help with staff shortages. These tools grew fast during and after the COVID-19 pandemic and showed promise in helping care delivery. But their use is not the same for all patient groups.
A recent study looked at more than 1.28 million ED visits. It found that only about 17.4% of patients used patient portals during their visits. This low use is not because the portals are unavailable. Instead, it is linked to social and demographic factors like race, gender, insurance type, income, and education. For example, male patients, Black patients, and those without commercial insurance are less likely to use these portals during ED visits. These differences reduce the benefits of digital health tools and cause uneven access to timely information and care coordination.
When patients do not use portals, it can make existing healthcare gaps worse. Such patients miss chances for early registration, visit tracking, digital checks, and discharge planning. This leads to longer wait times and weaker care follow-up. This issue is especially important in emergency care, where time is short and good communication matters.
These problems are made worse by busy ED settings, where staff have little time to help patients use digital tools.
Artificial intelligence (AI) is being used more in emergency care to help with triage, patient guidance, risk detection, and care coordination. New models like large language models (LLMs) and machine learning now allow automated messages to patients and smoother workflows.
AI chatbots and 911-based triage services help reduce unnecessary ED visits by guiding patients to the right care before they arrive. Systems like MD Ally and RightSite check how severe a case is during emergency calls and send low-risk cases to virtual visits or home care. This helps lower overcrowding and cost. These systems also help arrange transport or medicine, addressing many patient needs.
Chatbots from companies such as Buoy, Ada, and Clearstep help patients check symptoms quickly. They encourage people to make good choices about visiting the ED or using other care. This early contact can reduce pressure on emergency services. But not everyone has equal access to this technology, which affects who benefits.
Inside the ED, AI tools help doctors with patient triage, risk sorting, and deciding care order. For example, Stochastic AI systems suggest Emergency Severity Index (ESI) scores so staff can spot high-risk patients who need quick care. Mednition sends alerts in real time for risks like sepsis. This is important because many sepsis cases (about 6 in 10) are missed at first triage.
Viz.ai combines image analysis and patient data to speed up stroke treatment by around 40 minutes. Heartflow uses AI with CT scans to check heart blood flow without surgery, helping diagnose chest pain faster.
Conversational AI helpers collect patient histories, note symptoms, screen social health factors (like housing or abuse), and give patients clear updates. These tools lower nurse workloads during staff shortages and improve patient satisfaction by keeping them informed.
Apps like Fabric let patients register before arriving, check their visit status, complete fast digital assessments, and set follow-up appointments after discharge. These tools help care run smoother, reduce paperwork, and stop patients from leaving without being treated.
Still, uneven use of these tools among different groups cuts their overall effect. Research shows digital gaps continue because of social factors like education and income. This calls for extra actions to make adoption fairer across all groups.
Research using frameworks like the eHealth Equity Framework points to the need to focus on fairness when creating digital health plans. Important points include:
With these steps, healthcare groups can improve portal use, digital engagement, and fair access to care.
AI can improve ED workflows by helping with clinical decisions and by automating everyday tasks.
Using AI automation helps hospitals manage resources while improving patient experience and care quality.
Those managing hospitals or IT systems can take these actions to boost digital health fairness and patient portal use in emergency settings:
These steps help hospitals reduce barriers for many patient groups and make emergency care better.
Emergency Departments have special challenges in giving quick and fair care. Digital health tools and AI can help, but only if equal access is kept in mind. Without that, gaps may grow bigger. Hospital administrators and IT leaders play a key role in making sure patient portals and AI tools are open and easy for all patients. By working on social and digital divides and using AI well, US healthcare can improve patient involvement and care results in emergency settings.
Pre-ED triage helps reduce unnecessary emergency department (ED) visits by guiding patients to the appropriate level of care using AI chatbots and 911-integrated triage services. It enhances patient decision-making and system efficiency by diverting low-acuity cases to virtual or home-based care, thus lowering healthcare costs and avoiding ED overcrowding.
911-integrated triage services like MD Ally and RightSite assess the severity of conditions during emergency calls and redirect low-acuity cases to virtual care options. They provide additional support like prescription assistance or transportation, helping to reduce avoidable ED visits and EMS usage, while aligning incentives between payers and emergency services.
LLMs enable personalized messaging and communication that improve patient engagement and clinical outcomes for ambulatory-sensitive conditions (ASCs) such as heart failure or COPD. Startups like Hinge Health use LLMs to tailor interactions and reduce unnecessary ED visits by managing chronic illnesses effectively outside hospital settings.
AI tools like Stochastic and Mednition support clinical decision-making by accurately classifying patient acuity and identifying high-risk patients early, improving resource allocation. AI-driven command centers optimize throughput, predict crowding, and balance staffing, easing bottlenecks to maintain efficient patient flow and timely care delivery.
LLMs can track patient progress against clinical guidelines in real time, flag delays (e.g., missing tests), and prioritize care. This granular patient-level monitoring can accelerate appropriate discharges and optimize bed management beyond operational metrics, improving adherence to care standards and reducing crowding.
Apps like Fabric engage patients before and during ED visits by enabling pre-registration, providing visit progress updates, and offering digital discharge processes. These tools reduce documentation burden on staff, improve patient navigation, and decrease the rate of patients leaving before being seen, thereby improving care continuity and satisfaction.
Conversational AI agents can collect patient history, triage severity, pre-populate clinical notes, screen for social determinants of health, and guide patients through their ED stay in understandable terms. This reduces nurse workload, shortens wait times, and enhances communication, supporting better patient engagement and streamlined workflows.
Viz.ai uses deep learning to analyze imaging (CT, ECG) for rapid stroke and vascular care decisions, reducing treatment time. Heartflow assesses cardiac blood flow noninvasively via AI-driven CT analysis to avoid invasive procedures and expedite chest pain patient discharge, enhancing safety and efficiency in ED triage.
Unlike 911 triage solutions where ED diversions are clearly measurable, digital front door tools face complex attribution challenges as they need to demonstrate impact on patient behavior and healthcare utilization earlier in the care journey, requiring alignment of incentives across stakeholders and longitudinal outcome tracking.
Studies show low patient portal usage during ED visits, especially among males, Black patients, and uninsured populations, which limits the benefits of digital tools. Promoting equitable access to digital engagement before and during ED visits enhances participation, improves communication, and supports better health outcomes across diverse patient groups.
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