CHARLESTON, W.Va. -- Some American hospitals are starting to use reservation systems in their emergency departments, but none of those hospitals are in West Virginia, an official said this week."Based on some initial feedback from hospitals, we've not heard of hospitals in West Virginia looking into the possibility of initiating a check-in system," Tony Gregory, vice president of legislative affairs for the West Virginia Hospital Association. "[It seems to be] a trend in more urban markets as a way of dealing with inappropriate use or overutilization of emergency rooms."According to Bloomberg News, more than 100 hospitals are using the ER reservation systems, which allow patients to see wait times for their local emergency rooms online or even reserve a place in line at the emergency room from their homes.More than a dozen Chicago-area hospitals have implemented similar systems in their emergency rooms, according to a recent article in the Chicago Tribune.The idea is to cut down on the unpredictable nature of wait times in emergency rooms.But Gregory said using reservations might have a downside, too."I've heard some critics say if someone is able to make an appointment, it's not an emergency," Gregory said. "It may encourage the misuse of emergency rooms. That's something to be concerned [about]."Having appointment times may also encourage the incorrect assumption that emergency rooms are simply clinics, Gregory said.With the chaotic nature of emergency rooms, it's difficult to ensure that a patient will be seen at a given time, Gregory said."There's no way to guarantee appointment time," he said. "If a hospital gets a [more critical] emergency patient, the patient with appointment would wait until the situation is passed, which could be different than the appointment." That could lead to even more dissatisfied patients, he said.An official at Saint Francis and Thomas Memorial hospitals had the same concerns."If you encounter a variable that pushes the time longer that is posted it creates an unhappy patient for false advertisement," Tim O'Neal, director of the Thomas and Saint Francis emergency departments, said through a hospital spokeswoman via email.Charleston Area Medical Center, too, has no immediate plans of taking reservations at its emergency rooms, either."CAMC is not working on anything like this right now, but would study the concept if it is something that benefits patients," CAMC spokesman Dale Witte said. "In the mean time all hospitals are using various processes to reduce overall ER throughput."According to the most recent data available, emergency rooms across the state had 1.1 million patients in 2010, Gregory said. Hospital emergency rooms are obligated by federal law to screen and stabilize -- essentially treat-all patients regardless of their ability to pay, he said.Hospitals are constantly evaluating how best to manage emergency rooms, Gregory said.The state's high number of chronic illnesses and a lack of resources for those with behavioral health issues and substance abuse problems are contributing factors to an overcrowding of hospital emergency rooms, he said."These are fundamental and basic challenges within West Virginia's overall health care system," Gregory said. "There's also the issue of the uninsured and underinsured, which may use the emergency room as primary care."Another factor for more urban hospitals, like CAMC and West Virginia University health care facilities, is that they are trauma centers and teaching hospitals and trauma cases from all over the state are sent to them, he said.Reach Lori Kersey at email@example.com or 304-348-1240.