Emergency medical services (EMS) programs are exploring using virtual consults to support their role in providing lifesaving and emergency mitigation medical services.
In 2014, Houston launched a program that has reduced 80% of the number of unnecessary emergency visits. Referred to as ETHAN (Emergency TeleHealth and Navigation), the program connects paramedics to a specialist for a video consult via a tablet if the EMS team determines a patient does not need to be immediately rushed to a hospital.
As recently reported in Governing and the Western Journal of Emergency Medicine, the program has solid results as it is approaching its 10,000th patient encounter. ETHAN was reported to have:
- Prevented 6,000 unnecessary ER transports
- Reduced costs to treat a patient (from the average $2,200 cost to transport someone to the ER to a virtual treatment cost of $220).
- Improved productivity (median time from EMS notification to unit back in service) by 44 minutes (39 vs. 83 minutes, median), equating to approximately 2.1 times greater utilization (dispatches per day) vs. the control group
The average teleconference visit clocks in at about 7 minutes. The study concluded that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity.
EMS agencies recognize the benefits which a virtual consult would deliver. In an EMS Working Group study, 77% of all respondents felt that the prehospital use of video would be beneficial in certain patient care situations. Positive benefits of video telemedicine were summarized as follows:
- Live video is needed for stroke assessment validation/enhancement.
- Best use for Community Paramedicine (CP‐MIHC) and “gray zone” patient presentations.
- Best use for patient refusals and risk management documentation.
- Situational awareness from EMS to PSAP and ED will be enhanced.
- Best use in rural areas with extended transport times, and where EMS staff who do not have high call volumes for skills maintenance.
- Cameras create a more professional interaction (EMS crews and patients “behave” better).