What You Need to Know About EMS Telemedicine Webcast

The webcast covers the technology, how to approach the concept, reasons for and against it, what to consider in implementation and much more. Is EMS telemedicine right for your agency? Listen now to this free webinar.

Q&A Session

The following questions were asked by attendees during the live presentation of the webcast and answered by presenter Curt Bashford:

1. If an EMS-based physician evaluates and treats a patient via telemedicine and the patient does not need to be transported to the hospital, how can the doctor bill for this? How does EMS get reimbursed? Under the existing EMS transport-based reimbursement paradigm, it is an issue. From what we have been hearing, some systems are looking at working out arrangements with hospitals and insurance providers to approach this at a “system” level. There is belief among some that under coming healthcare mandates, hospitals and payers will be pushing for this by necessity. There are also other levels you can look at it from. For example, for EMS, if providers spend less time, they are freed up to handle more calls, thus reducing the equipment (ambulance) and personnel requirements, which relates to savings  (see the reference to Tucson’s Alpha Truck program mentioned in the full article).

2. You spoke about reliability and ease of use. Do you feel most systems are stable and require little oversight on the side of responders? These systems must be easy to use, robust and reliable. There are only a few companies who do this in the EMS setting and I can only speak specifically to General Devices products. For those, yes, ease of use and robustness are built-in. For standard off-the-shelf solutions, you had better bring an IT person for a ride-along. The other wild card is the wireless connection—how good and stable is it for your area? This is where proper planning and designing the system right from the start comes in. Don’t attempt live streaming video if you don’t have the bandwidth most of the time. 

3. What is e-Net Messenger? e-Net Messenger is a secure, robust public safety-type instant messaging system that allows you to attach text, voice, pictures, video clips, etc., so it can be used as an inexpensive EMS telemedicine tool from laptop or mobile devices.

4. What feedback are you getting from ED physicians? Varied as expected. Those that are technophobic are less receptive of course, but even they like recorded refusals! Those physicians who are tech savvy and think ahead, like Dr. Ray Fowler, are interested, but again, the application must make sense for their specific situation. In many cases, it is specialty physicians and not the ED doctors who are pushing for telemedicine.  But don’t forget to get buy-in from the ED doctors. It is also an issue of time availability for the ED physicians. Centralized call centers may be appropriate to take the load off the ED.

5. Can information be saved to be reviewed for QA? Yes. It should be a design consideration, but configurable at the option of the system admin.  QA, training and legal documentation are great attributes.  You will want to develop the policy on if/what gets recorded and who has access.

6. Has anyone utilized iSTAT for various lab testing in conjunction with other devices?  Good question & one I’m interested in too.  We met with the iSTAT people years ago when we were developing home-healthcare telemedicine. At that time, there was questions around transfer of CLIA licensure. Obviously iSTAT type results could play a big part in treat & release community paramedicine as part of EMS Telemedicine.

7. What is ACEP’s position on this advance in patient care? I believe that ACEP has been working with the ATA (American Telemedicine Association) on similar issues. They will likely want to see study data before taking a position as an organization.  

8. Are there any deployments outside of the U.S.? Yes, but not currently ours. We have had a lot of interest from the Middle East and some other areas. Many areas are ahead of America when it comes to EMS telemedicine. Some because of necessity born out of lower level EMS care, others as an adjunct to patient care in a socialized or single-payer healthcare system, e.g., Europe.

9. Can the ambulance send live data from the patient monitor to the hospital? No, not live streaming data, just snapshots in time or 12-lead ECGs. The common EMS monitors do not offer this capability, but they should. Ask your manufacturer for this feature!

10. I currently have a hotspot in my vehicle that I use for ePCRs. Can I use that data plan for telemedicine or do I need another data plan? You can use that same plan, however understand that you are sharing the available bandwidth among connected devices (when doing simultaneous activities). If you are not sending an ePCR, you have the full bandwidth available to EMS telemedicine—go for it!