So what does all this mean to EMS? The use of telemedicine in EMS will ultimately be determined by four factors:
- Can it be done?
- Is it needed?
- What will it cost and who will pay for it?
- What it will mean to the practice of EMS?
The technology and the effect-on-professionalism issues are largely non-issues. Needs, while yet to be proven, appear to be real. The most serious challenge to EMS telemedicine is the financial one, having to do more with the current economic and political climate than anything else. Despite strong arguments in favor of the economics of telemedicine, will municipalities be able to afford more than the level of service they are currently providing, and will reimbursement become available?
What we need now are people with the energy, vision and ingenuity to take on this challenge and objective studies that demonstrate what works and what doesn’t. We encourage the EMS profession to take a close look at EMS telemedicine and discuss its merits and weaknesses objectively. Those who preceded us brought us to where we are. What will we leave for those who follow us?
1. Tucson Channel 12 News. ER-Link.
2. NBC 33 News. Medical Breakthrough: Ambulance Cameras.
3. Sakles JC, Mosier J, Hadeed G, Hudson M, Valenzuela T, Latifi R. Telemedicine and telepresence for prehospital and remote hospital tracheal intubation using a GlideScope™ Videolaryngoscope: A model for tele-intubation. Telemed J E Health 17:3, 185–188, April 2011.
4. EMSWorld.com. Baton Rouge Launches EMS Telemedicine Program, March, 2009.
The author wishes to extend a special note of appreciation to those who contributed to the preparation and review of this article: Dr. Roy Alson, Head of the Section on Prehospital & Disaster Medicine, Associate Professor, Wake Forest University School of Medicine; Dr. Ethan Brandler, EMS Medical Director, SUNY Downstate Medical Center, NY; Dr. Raymond Fowler, Professor of Emergency Medicine, University of Texas Southwestern at Dallas; Chad Guillot, EMS Director, East Baton Rouge Parish, LA; Dr. Cullen Hebert, Critical Care Medicine Services, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA; Mr. Randy Kearns, MSA DHA(c), School of Medicine at the University of North Carolina; Dr. Steven Levine, The State University of New York Downstate Medical Center; Mr. David Ridings, EMS Assistant Chief, Tucson Fire Department, Tucson, Arizona; Mr. Michael Smith: BSEE, MSBME, C.E.O., General Devices.
Curt Bashford is the president of General Devices and has held many other positions within the company. He holds a BS in Electrical Engineering and a master’s in Biomedical Engineering, and is a former EMT. His experience at General Devices spans 25 years and includes design of many devices used in EMS for sending, receiving and managing information, FDA Regulatory, and managing the design and installation of numerous pieces of equipment, including FDNY, Nassau County EMS, Tucson’s ER-Link and Baton Rouge’s BR Med-Connect. Curt has spoken at conferences, has served on discussion panels and was a member of the DOC NTIA Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities.