Freestanding emergency departments would speed care to Anchorage patients 24/7

What would it be like to have a full-service, professionally staffed emergency department ready to meet the needs of people who live and work in Eagle River and South Anchorage? As an emergency department physician who has cared for patients in Alaska for many years, I believe that diversifying and enhancing access to emergency medical care is critically important for our community.

There is a fair amount of misinformation going around the community about the freestanding emergency department model (FSED) and its role in the health care continuum. Before Alaskans can make a decision as to what they believe is the best course of action, I think it is important to clarify some of the misperceptions.

While the FSED model is new to Alaska, similar EDs have been operating for more than 30 years in the Lower 48 states. Swedish Medical Center, in affiliation with Providence Health & Services in the state of Washington, operates at least two of them. Alaska Regional's parent company, HCA, currently has 45 of these hospital-owned facilities across the United States.

Designed to provide 24/7 emergency services, an FSED is similar to a hospital-based emergency department without the physical attachment to a hospital. Board-certified emergency room physicians and experienced support staff are fully prepared and equipped to diagnose and treat the majority of medical emergencies, using the key diagnostic services needed by the majority of patients who come to the emergency department.

It is important to note that the vast majority of patients seen in emergency departments across the state do not require hospitalization and are discharged the same day. On average, 10 percent of Alaska Regional's visits turn into a hospital stay, leaving a large number of patients who could be treated at an FSED and released to their homes versus traveling additional distances to a hospital. In addition to saving travel time, patients will also experience reduced wait times within the facility.

When it comes to treating life-threatening medical conditions, access to immediate diagnosis, stabilization and initiation of care protocols is critical to achieving the best outcomes. The time saved by initiating care locally can be used to facilitate assessment, begin treatment and alert the receiving hospital so they are ready and waiting with medical teams and available services in place as soon as the patient arrives.

We will work closely with Anchorage's fire and EMS teams to ensure patients are delivered to the facility that is most appropriate for the level of care they require. For example, an ambulance delivering a stroke patient will go directly to the hospital. Patients with life-threatening emergencies who arrive to an FSED by private transportation will be rapidly diagnosed, stabilized and transferred to a hospital of their choice.


In addition to being open 24/7, FSEDs accept Medicare -- an important factor for the largest growing population in Alaska -- our senior citizens. Similar to the hospital-based ED at Alaska Regional, all patients are welcomed, regardless of their ability to pay for care.

The introduction of FSEDs is part of Alaska Regional's overall strategy to increase our community's access to health care. Last fall, the hospital acquired the Senior Clinic in South Anchorage, thereby providing financial stability to the clinic and increasing seniors' access to comprehensive, patient-centered care. Additionally, plans are currently underway to open a community health clinic in Mountain View to better serve a population with limited local access to health care, which causes many residents to utilize hospital emergency departments for routine care.

Officials at the Alaska Department of Health and Social Services have a big decision to make as the number of beds allowed in our service area is determined by the Certificate of Need process. I believe that diversifying access versus placing all of the beds on one already-busy campus is the right answer for our community. This approach will also serve to decrease the burden on the Providence Hospital campus so they are able to support the pediatric specialty program without adding additional beds -- a cost savings for them as well as the state.

The state is interested in hearing from community members so I encourage you to share your thoughts. You may submit written comments through the end of May to Alexandria.Hicks@alaska.gov. For more information about Alaska Regional Hospital's plan, please visit AlaskansForEmergencyRoomAccess.com.

Jennifer Dow, M.D., is medical director of emergency services at Alaska Regional Hospital and a member of Denali Emergency Medical Associates.

The views expressed here are the writer's own and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary(at)alaskadispatch.com

Jennifer Dow

Dr. Jennifer Dow is medical director of emergency services at Alaska Regional Hospital.