1) It is a phone based system
I have to call the admitting department. The admissions person makes phone calls to find a receiving doctor. The admissions person has to call to find a nurse and a bed. There is no integrity of the patient report with so many phone calls.
2) I have to call hospitals one at a time.
I never buy anything without comparing 10 website and reading tons of customer reviews. I should be able to screen multiple hospitals at once.
3) Each receiving hospital has a different admissions process
Sometimes I talk to another nurse. Sometimes I talk to a secretary. Sometimes they want a face sheet and other times they want a sheave of paperwork.
4) I can't call the transport company until a bed is secured
In Sept 2011, the AHA Journal Circulation published a study "Causes of Delay and Associated Mortality in Patients Transferred With ST-Segment-Elevation Myocardial Infarction" that showed 26.4% of all transfer delays were caused by "awaiting transportation"
5) EMTALA has no time restrictions.
It has been common knowledge that transferring patients take a long time. Two studies last year proved that it takes way too long. One study showed that mortality doubles in heart attack patients that wait longer than 30 minutes to be transferred - less than 12% of transfers met this goal. A stroke study found a median transfer time of 104 minutes in spite of a median distance of 14.7 miles!!