Cole Hospital 'fast track'
New system should reduce ER congestion

Charles Cole Memorial Hospital in Coudersport this week took the first step toward a "fast track" clinic to provide service to non-emergency patients who come to the hospital for treatment.

The clinic, which Cole is calling "Express Care," is located in the Irwin Medical Arts Center on the hospital campus.

Initial staff includes a registered nurse, Charleen Rosenberry, and a physician's assistant, Michael Joyce.

Typically, patients are treated in the fast-track process for non-urgent complaints. This enables the emergency room staff to more promptly treat patients who are acutely ill or who have traumatic injuries.

Financial issues and reimbursement policies of medical insurers are a major factor in the opening of Express Care. Some insurers erected barriers to prevent patients from using the ER.

"For the rising number of uninsured, the ER is their family doctor," said Rick Wade, spokesman for the American Hospital Assn. "You also have a number of doctors who tell patients to go to the emergency room because their schedule is too full."

Patients who lack insurance often have no other choice, said Cheri Rinehart, of the Hospital and Health System Assn. of Pa. ERs are increasingly crowded because more people have lost insurance or have poor coverage.

This safety net function can be a financial drain on hospitals, Rinehart said.

But operating an emergency room still can be a profitable business, said Glenn A. Melnick, a consultant with RAND in Santa Monica, Calif. For ER patients admitted, hospitals generate on average an excess of revenues over expenses of $1,220 per patient, Melnick said.

Cole's Express Care is open from 4:30 p.m. to 8 p.m. Monday through Friday. Weekend hours may be established later.

It's a walk-in clinic only, for now, but that could change in the coming months.

Patients will be billed by the hospital for services provided at Express Care.

"It is important to ensure that patients are aware of the true purpose of the clinic while encouraging them not to view the clinic as an alternative to their primary care providers," according to an internal memo circulated at the hospital. "Conditions that may be treated at Express Care include colds, flu, intestinal viruses, sore throats, strains, sprains, minor bone and joint injuries, minor wounds, infections (abcesses, etc.), minor headache, rashes, dental pain, gynecologic problems, minor burns and insect bites."