1 / 16

Enhancing Emergency Medical Services with Telehealth: A Cost-Effective Model

Explore a tele-EMS program integrating video conferencing to improve prehospital triage, reduce ambulance transports, and cut costs. Case study in Houston, TX, showed significant benefits.

rpiper
Download Presentation

Enhancing Emergency Medical Services with Telehealth: A Cost-Effective Model

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Designing a Telehealth-Guided Alternative Delivery Model for Emergency Medical ServicesAmerican Medical Informatics AssociationNov 6, 2018 James Langabeer, PhD Michael Gonzalez, MD Andrew Winburn, MS Tiffany Champagne-Langabeer, PhD

  2. Disclosures • Nothing to disclose and no conflicts of interest

  3. Background • Estimated 30-40% of EMS calls are non-urgent, primary care related • Ambulance and paramedic crews are limited • Telehealth offers a potential solution

  4. Objective • Assess the feasibility and cost-effectiveness of a tele-EMS program integrating video conferencing

  5. Study Setting • Study Setting: Houston Texas (4th largest metropolitan area in US) • One of the largest fire-based EMS crews in the nation (3700 EMS responders/firefighters) • Division of the Houston Fire Department (85% of all incidents involved EMS; 15% fire) • 300,000+ annual medical incidents • 63 Ambulances + 175 engines/ladder trucks/ squad vehicles for response

  6. Study Design • Case control study design • Inclusion criteria: adult patients with non-acute symptoms • Intervention involved an alternative to ‘treat & transport to ED’ model: • Telehealth-guided triage and disposition • Alternative transportation • Network of community-based health centers • Mobile health solutions involving telehealth, clinic scheduling, taxis, and HIE access • Primary outcomes: cost and reduction in ED ambulance transports

  7. Technology • Commercially available telehealth app on all paramedic tablets • Video transmitted (and stored) to EMS base station physicians • Dialogue between patients, medics, and doctors (average of 3 minutes)

  8. The Process Time, Costs

  9. Process Flow Diagram

  10. Patient Navigation

  11. Outcomes

  12. Results • 14,760 patients in 3 full years • Significant reduction in ambulance transports (74% to 12%) • Faster unit turnaround times (44 minutes) • $103 average reduction in cost effectiveness • $1.52 million total benefit over three years

  13. Barriers • Patient education and resistance (shared decision making) • Technology and systems development (costs, interoperability) • Financing and reimbursement (policy issues)

  14. Conclusions • Telehealth can improve prehospital triage and patient navigation • Telehealth offers an alternative to the traditional EMS ‘treat and transport’ model • Telehealth should be explored and adopted in other geographies and municipalities • Barriers exist for widespread adoption

  15. References • Winburn A, Brixey J, Langabeer J, and Champagne-Langabeer T. (2017). A Systematic Review of Prehospital Telehealth Utilization. J Telemedicine Telecare, https://doi.org/10.1177/1357633X17713140.

  16. Thank You James.R.Langabeer@uth.tmc.edu

More Related