True or not, emergency rooms have a well-established reputation as places where patients who desire care immediately can end up waiting hours. Now, local hospitals from Burbank to the Conejo Valley are borrowing a bit from both Madison Avenue and Silicon Valley to change that: they have been erecting billboards promising shorter wait times, often through the use of texting and apps. Perhaps the most prominent campaign is along the Ventura (101) Freeway in the Conejo Valley promoting Los Robles Hospital in Thousand Oaks and West Hills Hospital in Woodland Hills, both properties of Hospital Corp. of America of Nashville, Tenn. The signs feature a pair of cyclists and a number viewers can text for wait times. “When patients are in pain, they want to be seen fast, and just because a hospital is closest doesn’t mean they’ll be treated faster or more efficiently,” said Adam Blackstone, vice president of marketing at Los Robles. When a person responds to the freeway ads by sending a text, the message goes directly to a scheduling computer at the nearest HCA hospital emergency department. The computer sends back an average wait time based on the previous four hours. Also, the phone prompts the patient to download an app called iTriage, which allows the patient to input information to help the ER personnel decide the urgency of care and scheduling. Another app allows users to track wait times and notify the hospital when they will arrive at the ER. HCA is perhaps the most aggressive advertiser, but other local hospitals have latched on to the trend, which actually got started several years ago but has picked up only recently. Dignity Health, based in San Francisco, has billboards in the Valley with messages telling people how to schedule an ER visit at the chain’s Northridge Hospital Medical Center. Jason Brown, chief executive of BPD Advertising in Delray Beach, Fla., which specializes in hospital marketing, said that about five years ago large hospital groups, including Ascension Health in St. Louis, took notice of the bad publicity surrounding ER care and took steps to counter it. Better organization and technology in the ER have greatly improved care, and companies want to advertise that fact. “At first it was primarily an HCA initiative, but it’s not exclusive to them,” Brown said. “As more hospitals have moved to correct operational issues, HCA and others will pivot to other differentiators in the market.” Brown has worked with some hospitals that promise a 30-minute guarantee for an ER visit. Other hospitals have adopted a “wait-at-home ER” model where patients are encouraged to stay home until the ER personnel can see them. “They’ve taken different paths, and they’ve all been successful,” Brown said. “It’s all about convenience.” HCA’s campaign launched four years ago, but it only recently achieved a high profile locally because a large number of billboards along the freeway became available. The City of Thousand Oaks has a law against billboards, so the freeway locations were the only ones that would reach the intended audience, Blackstone said. The campaign, which also involves bus benches, websites, print and direct mail advertising, has resulted in a significant uptick in traffic, he said. Los Robles received about 2,400 texts during March, and expects to see about 45,000 patients this year. “Los Robles has seen an increase in texting and ER usage, and many of the other hospitals have as well,” said Blackstone, who was unable to provide similar figures from last year and would not disclose the budget for the campaign. Multiple players Dignity Health, which operates St. John’s Hospital in Oxnard and St. John’s Pleasant Valley Hospital in Camarillo in addition to Northridge, has a broad campaign advertising its ER services with billboards, TV, online search, print and posters at local malls, said Paul Pettite, senior director of marketing. The ads promote Inquicker, an online program that allows customers to get an estimated wait time for an ER visit, select a time and then wait at home. Dignity implemented the technology last June, but didn’t start marketing it until November. Since the campaign launched, the number of Inquicker users in the region has nearly tripled. “It’s not for true emergencies – if you have a heart attack you should call 911—but if you’re sick in the middle of the night, or have a fracture, it might be for you,” Pettite said. “We find this is widely used by the younger demographic of 35 and under.” HCA and Dignity aren’t the only players in the Valley to market their ER services. Providence Health & Services, which has three hospitals in the Valley, has been advertising its ER services via direct mail but declined to discuss the matter in detail. Brown, the advertising agency executive, said the main challenge for ER campaigns could be their success. “If volume spikes, that’s an operational challenge for hospitals,” he said. “As more people see your message, more expect the service, especially if there’s a 30-minute guarantee. You have to add staff and better your operations.” The ads also have not been without some controversy. Last month, a state representative in Louisiana proposed a bill to prohibit hospitals that receive state funding from advertising their ER wait times, arguing that it encourages people to go to the hospitals rather than the less-expensive option of making an appointment with their primary care doctor. But Blackstone at Los Robles said he doesn’t believe the ads encourage misuse of the ER. “Those who go to the ER to avoid their doctor will do so without prompting from an advertisement,” he said. One thing that at first glance might appear surprising about the campaigns is that ERs have historically been difficult programs for hospitals. On the one hand, that is where the uninsured typically showed up for care, and hospitals by law are required to care for them, even if they can’t pay. At the same time, ERs often are the gateway to the system; ER patients are often admitted for overnight stays at the hospital. Reform impact Martin Gallegos, senior vice president at the Hospital Association of Southern California industry trade association in Los Angeles, noted that ER advertising started before health care reform, but the trend might be picking up due to the financial impact of reforms. As more people have insurance, there will be fewer uninsured people walking into the ER, potentially making the operations more profitable. Also, the goal of reform is to avoid expensive hospital stays, so hospitals are trying to promote all their outpatient services, not only emergency rooms. L.A.’s radio airwaves are full of ads about cancer centers, spine centers and diabetic clinics. “For the most part, services provided in the ER are generally not necessarily profitable, but some hospitals do very well in ER,” Gallegos said. “I assume if they are advertising it, they are doing well with their ER.” Blackstone said HCA’s billboard campaign is an ongoing effort with no end date. However, this month he’s launching another campaign to promote ER visits. This one will focus on pediatric ER, where Los Robles has expertise. The campaign will include billboards, movie theaters and online ads. “Text ER service will be a big component of the campaign,” he added.