The Impact of Telehealth-Enabled EMS on Ambulance Transports

From JEMS:

Researchers in Houston wanted to measure the ability of using a combination of telemedicine, social service pathways and alternative means of patient transportation for patients who didn’t require an ED visit by ambulance. It was conducted by the Houston Fire Department and termed the Emergency Telehealth and Navigation (ETHAN) program.

Eligible patients included those with primary care-related complaints. The most common categories were “abdominal pain,” “sick,” “injury/wound” and “other pain.” Inclusion criteria included the following: Able to have full history and physical exam by paramedics (non-emergent conditions); age > 3 months; ability to communicate in English; normal vital signs; absence of fever in chronically ill patients or those over 65; ability to care for self; access to private transportation; and access to pediatrician for pediatric patients.

Patients with chest pain, acute neurological changes, altered mental status or difficulty breathing, syncopal episode, suspected non-accidental injury or neglect in pediatric patients and minors with no legal guardian on site were excluded.

Once identified, the patient was interviewed via video by an emergency medicine physician working in the Houston Emergency Center that provides regional telecommunication and dispatch for EMS. If the physician and patient agreed that their condition was non-emergent, the physician would pursue one of three pathways.

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