From 2006 to 2014, emergency department (ED) visits increased by 14.8% with 140 million visits in 2014. Despite this increase, the overall number of EDs decreased during this time. Though ED crowding is recognized as a public health crisis, it persists and is associated with longer wait times to be seen, increasing number of patients who leave without being seen (LWBS), poorer access, worse patient experience, decreased quality of care, and adverse consequences on health system finances. Thomas Jefferson University sought to improve these outcomes by leveraging their telehealth program into the Emergency Department, instituting a tele-triage program to see patients earlier, place orders, and help patients get through the ER more quickly. This talk describes the program, implementation, results, and lessons learned of using telehealth in this novel approach.