The healthcare industry has seen and will continue to see many changes which impact the viability of certain care structures and even facilities that can withstand the change. Value-based care has worked for some but has left others in the dust as they struggle with changing the way they provide care. The increasing closures of hospitals aren’t just alarming for the leaders and employees of the organization, its effects can be felt by other healthcare facilities and services in the area and even more so by the patients who are forced to seek care elsewhere.
Take for example the impending closure of Pioneer Community Hospital located in Stuart, Virginia. The first phase of the shutdown is closing the doors to its ER and this is expected to directly affect the local EMS. Patrick County’s Emergency Services Coordinator is anticipating an increase in transport times from 30 minutes to possibly 3 or 4 hours- a significant consequence to a department comprised of volunteer EMTs. This will likely continue to be an issue, especially in rural areas where hospital closures are at their peak. Lack of funding for services in these areas only exacerbates the situation.
There has been numerous success EMS telemedicine stories of departments utilizing virtual health to reduce unnecessary transfers that take up critical periods of time that could otherwise be used for serious medical conditions. It also reduces costly expenditures and reimbursements that are spent caring for an illness that is not urgent. These types of applications could be incredibly helpful for departments who lack the funds or are seeing changes in their healthcare landscape that are severely impacting the service they provide to residents of their service area.
Wake County EMS, located in North Carolina, completed a successful pilot with RelyMD. Over a 1-month period the EMS department, one of the largest in the state, was able to reduce unnecessary transfers by 90% simply by giving their EMTs access to emergency medicine physicians who were able to see a patient in less than 10 minutes. The unique ability to see a doctor who specializes in urgent and unscheduled care needs surpassed the expected outcome and left the department with a lower expenditure that month and the ability to see more patients. Because the county is so spread out, many times just getting to a patient can take up valuable time, being able to consult with a doctor who can help provide a treatment plan and follow-on care that allowed the patient to remain at home gives the EMT team the opportunity to see more patients, faster. The department head also found that this service gave their team great satisfaction in their job knowing that they were contributing to healthier patients with real treatment plans.
A program called ETHAN based in Houston, Texas has seen similar long-term success. By enabling physicians to communicate directly with patients through telemedicine, over 700 patients have been evaluated and 80% of those evaluations have resulted in patient care that didn’t require an ambulance transfer. The ETHAN program has been in effect with multiple revisions for nearly 8 years. ETHAN is funded through the Texas 1115 Healthcare Transformation Waiver program.
There are many EMS departments who like the above-mentioned Patrick County Emergency Services who could benefit from EMS telemedicine, but unlike the ETHAN program, funding sources are limited.
The most popular way EMS departments are funded is by their local municipality, better known as the local government and sometimes municipal taxes based on the size and population of the area they serve. There are also private and for-profit ambulance services, these are funded through user fees or by paid contracts through local municipalities. And no matter which way an EMS department is funded, they’ll also be relying on Medicaid and Medicare for reimbursements. Billing in EMS is a complicated overlap of government and private reimbursement that is only paid out when patients have been transported and can be highly dependent on a number of factors like distance the patient is transported, level of service, and more. Not surprisingly, new technologies and ways of providing care are often the last to be looked upon when providing additional monetary support when most costs that are reimbursed are utilized for staffing.
As EMS is combined more and more with virtual health and proves to be a valuable service that enhances healthcare for all involved, funding for these improvements must become a priority.
There are a number of grants currently available in certain areas for the practice of telemedicine by EMTs:
If you are interested in learning how a pilot between your EMS program and RelyMD could help reduce unnecessary transfers for your department, please fill out the form below for more information.
September 22, 2017