The Next L.A. / Reinventing Our Future : Health Care : IDEA FILE: The Home Emergency Room

WHAT IT IS: Every home would be an emergency room.

HOW IT WORKS: Every household is equipped with a computer and video phone. Patients with medical emergencies dial 911 and are hooked into a dispatcher who talks them through emergency procedures--such as CPR--while paramedics are dispatched. Or in less serious cases, a doctor would conduct a video examination and suggest a course of action.

BENEFITS: Emergency rooms are clogged, often with people who don’t really need to be there.

SHORT-TERM OR LONG-TERM IMPACT: Long-term

SUPPORTERS: Those who envision this say that such a system could save lives, especially in a city like Los Angeles where traffic sometimes keeps paramedics from mounting a speedy response. Could prevent needless emergency room visits, thereby cutting down on costs. Might provide reassurance to anxious patients. Some hospitals and public service organizations already have medical information telephone lines, some of which enable callers to be immediately transferred to a medical professional.

OPPONENTS: In medicine, there is no substitute for human contact. Doctors might give substandard care if they are making decisions based on pictures, without being able to touch a patient or, for example, listen to his heart. Opponents also point out the liability problems for doctors. Additionally, a futuristic version of a clogged emergency room would occur as some patients might call 911 every time the baby coughs or grandma feels dizzy.

THE COSTS: In the billions. For the individual consumer, the costs would involve buying computers, telephones and other equipment to hook into system. The cost of equipping public hospitals, and the cost of maintaining system would fall on the government and therefore the taxpayers. In addition, to provide a truly universal system, some sort of government subsidy would probably have to be provided for the poor. In addition, private hospitals would have to absorb the expense of computers and other equipment--a cost that would probably be passed onto the consumer.

REALITY CHECK: Unlikely in the near future. Costs are too high and video phone technology is not widely available.