Making it possible for patients to text the ED for wait times, as several Hospital Corporation of America (HCA) facilities have done, takes more than just technology. As Gulf Coast Regional Medical Center has shown, it takes a good deal of staff preparation and internal and external education. Two years ago, the arrival- to-triage time was 45 minutes, and now it's three minutes; time-to-physician was greater than an hour, and now it's 30 minutes. Because wait times were to be made public, process improvement initiatives were instituted to lower wait times. ED nurses received education about the corporate flow measures by which their performance would be evaluated. A public education campaign was designed to ensure that prospective patients understood exactly what the posted wait times meant.