Telemedicine has provided healthcare with exciting opportunities. In this article, we’ll discuss why integrating telemedicine and community paramedicine with the 911 response is a game changer and why many areas are adopting this pathway into their protocols.
Telemedicine opens the door to various benefits for community paramedicine within 911 response. It gives patients peace of mind, allows advanced providers to make better triage decisions, allows community paramedic teams to employ alternate providers, and allows for advanced care in the field.
Many communities have seen the power of telemedicine and community paramedicine – but what happens when these elements are merged with the 911 response? Let’s talk about it.
How Telemedicine and Community Paramedicine can Integrated with the 911 Response
Some of you might wonder: can telemedicine and MIH-CP be integrated with the 911 system? How would this work in real time? In this section, we’ll talk about how telemedicine and EMS might combine with the emergency response – remember that the methods can vary based on the area, the type of dispatch center, and the protocols.
Here are several methods to integrate telemedicine and MIH-CP with 911 calls:
- Integration with dispatch and protocols
- Multi-unit response
- Integration with standard units/Alternative destinations
We’ll look at this process in more depth below.
Integrating Telemedicine and Community Paramedicine with Dispatch (And Local Protocols)
The first step in integrating telemedicine and community paramedicine with 911 is to get the protocols on board. In a community, everyone must be on the same page – this couldn’t be truer for community paramedicine, where everyone needs to be connected to make it work.
Once protocols have been developed that allow for alternative 911 responses, or at least a tiered response, the dispatcher will activate a separate community paramedic unit or a telemedicine-capable ambulance, and they will respond to the patient.
This response works similarly to any other EMS response – the dispatcher will go through a specific set of questions and criteria to determine if the patient qualifies for a full emergency response, a partial-community paramedic response, or a full community paramedic response.
Using a Multi-unit Response for Community Paramedicine and Telemedicine
When integrating community paramedicine with the 911 response, there will often be a multi-unit response – a regular ambulance will respond with the community paramedic unit. Why this option?
As any EMS system knows, getting an accurate read on a patient via dispatch information is challenging. Upon further assessment, many patients who are dispatched as a high priority will become downgraded. Likewise, many patients who are dispatched as low-priority will be upgraded when the paramedics make a final inspection.
How can this uncertainty about the patient’s condition be overcome? A multi-unit response can be the key for some systems. With this approach, a regular ambulance is dispatched with a community paramedicine/telemedicine capable unit. Whichever unit arrives on the scene first performs an assessment and relays the information to the other unit.
In this way, the patient can receive the care they need, and there’s no risk of dispatching a non-emergency unit to an emergent situation. Now, let’s discuss a final option for telemedicine and community paramedicine with a 911 response.
Integration of Telemedicine and Community Paramedicine with Standard Units
Finally, some areas will have EMS units equipped to operate as emergency response and community paramedic/telemedicine units. In the model, the ambulance responds to the 911 call as usual. When they arrive on the scene, they assess the patient and determine the treatment path.
The big difference is that these units have more treatment options than regular EMS units. They may also be able to transport the patient somewhere besides the emergency department. These units may also be able to provide more advanced emergency care, especially if they are cleared to have an immediate video call with an emergency physician.
Now that we’ve discussed how it works let’s look at the benefits of this integration.
The Big Benefits of Integrating Telemedicine and Community Paramedicine with Emergency Response
Integrating telemedicine and community paramedicine with 911 opens up improvements on both sides of the coin – improved 911 response/emergency care and better long-term care for patients who need a more holistic approach.
Here are the benefits of adding telemedicine and community paramedicine to an area’s 911 system:
- Better care for emergency patients
- Fewer super-utilizers, less ER crowding
- Help with responding to mental health and substance abuse calls
- More comprehensive application of community paramedicine
- Ability to incorporate more providers (EMTs)
In the following sections, we’ll go into more detail.
Telemedicine and MIH-CP Provide Better Care for Emergency Patients
First, telemedicine can improve emergency care – aside from community paramedicine. Let’s give an example of how this might work in real time.
Consider a patient who may be having a heart attack. Suppose the paramedic is trying to make a decision on whether the patient is having a serious heart attack (STEMI) that requires activation of the cath lab. In that case, they can immediately start a video conference with the ER physician, achieving expert consultation.
This is especially true for areas with limited staff or can’t employ ALS providers. The other area where telemedicine could benefit is when patients refuse services – the physician may be able to come on the line and convince them to be transported or clear the patient for refusal.
With telemedicine, the patient can still get high-quality care and some advanced interventions that would otherwise be difficult.
A Reduction in Super-Utilizers and ER Crowding
When community paramedicine is implemented with the 911 response, getting patients where they need to go becomes much easier.
First, telemedicine and community paramedicine can reduce super-utilizers by providing them with the care they need. Often, super-utilizers are consuming a high amount of 911 and emergency services because they are lacking in some other area – community paramedicine can find their needs and help them.
Second, with an alternative destinations program, there will be less ER crowding, and patients will go where they can get the most help.
Better Response to Calls Related to Mental Health and Substance Abuse
Anyone in EMS is aware of the rise in mental health and substance abuse-related calls. These incidents have seriously strained the regular 911 response, as they are not a “simple fix.” For example, if someone calls 911 because they sprained their ankle, there’s a clear and systematic process to aid that patient and help them recover.
However, with someone struggling with mental health issues and substance abuse, the pathway to recovery is not so clear. With that said, community paramedicine and mobile integrated health are in a better position to provide real help to these patients, as they can assess each person individually and provide a nuanced response.
Now, let’s discuss how telemedicine and community paramedicine open doors within the 911 response.
Telemedicine and MIH in the 911 Response Leads to a Wider Application of Community Paramedicine
Many areas would like to implement community paramedicine for their area but are struggling to find a good starting point. Perhaps there has been some implementation, but the area leaders feel that the role of telemedicine and community paramedicine could be more significant in the community.
Embedding community paramedicine with the 911 response might be the answer. When community paramedicine works as part of the 911 protocol, it raises the number of people who might benefit and maximizes the potential of the population.
Not only that, but it could also open up new funding opportunities related to the ambulance response.
Ability to Use More Providers
Finally, telemedicine and community paramedicine working with the emergency response team will raise the effectiveness of a given provider. For example, there might be an area where the ambulance is only staffed with EMTs. In this case, it would be difficult for these providers to recognize advanced ailments, such as a STEMI (as we mentioned before).
With telemedicine, EMTs can be the eyes, ears, and hands of the emergency physician, allowing the area to treat patients with advanced care that, typically, wouldn’t be possible.
Now, let’s go over a few final thoughts and conclusions.
Conclusion: The Benefits of Integrating Telemedicine and Community Paramedicine with 911 Response
Integrating telemedicine and community paramedicine with the 911 response is a natural and beneficial idea. Sometimes, we talk about “technology catching up,” but in this instance, it’s about health systems and protocols catching up with technology. With the ability to provide high-quality instant video chats, there are very few reasons physicians shouldn’t be using this to their advantage (and many are!).
How does it work? The dispatchers will screen patients and send a full emergency response or a community paramedic unit. Providers can assess the patient and determine the best pathway when they get on the scene. What are the benefits? Better emergency care for patients, less over-utilization, and the ability to extend the physician’s expertise to the field.
Contact Julota to learn how their software tools can help your MIH program connect with partners, gather good data, and sustain a strong community program.