swyMed_mobile_stroke_unit: mHealth Technology makes teleStroke and ET3 programs possible

mHealth Technology Takes ET3 from Concept to Reality

The long-awaited ET3 program is finally here! After delays caused by the pandemic, the Emergency Triage, Treat, and Transport (ET3) program went into effect on January 1, 2021. To support this initiative, swyMed and Logitech are working together to provide the mHealth technology (mobile real-time audio-visual communications) that makes the ET3 program possible.

To read more about ET3 and mHealth technology, visit Logitech’s blog here.

Developed by the Center for Medicare and Medicaid Innovation, the ET3 payment model is poised to transform emergency ground ambulance services by offering patients more options for care, connecting the Emergency Medical Technicians (EMT) and paramedics with distant providers or specialists via mHealth, and reducing unnecessary transports to the Emergency Department (ED). By reimbursing a wider range of on-site treatments, en-route consultations, and destination options, the ET3 initiative is expected to improve efficiencies while lowering overall costs.

The goal of the ET3 initiative is three-fold:

  1. Offer patients more care options and a higher quality of care,
  2. Reduce avoidable transports to the ED and thus also lessen hospitalizations, and
  3. Encourage EMS and patients to utilize alternate options that are better-designed to handle low-acuity cases that do not require an ED visit.

One of the problems the Center for Medicare and Medicaid Services (CMS) is testing with this program is that Medicare only reimburses ambulance services if the patient is taken to a hospital ED or other pre-designated facility; if the paramedics treat the patient on-site, then no payment would be forthcoming. This setup creates the perverse incentive for Emergency Medical Services (EMS) to transport patients to the hospital ED more often, even if the visit is not actually required, or they don’t get paid!

With ET3, CMS will reimburse a wider variety of situations for Medicare beneficiaries in a few key ways:

  • Increase the types of facilities that qualify as transport destinations.
  • Permit qualified medical providers to initiate and facilitate patient treatment on-site or via mHealth technology.
  • Allow medical care to be supplied by a qualified health care partner on-site or through an mHealth system.

How will the new program work?

When a 911 call is placed for a medical emergency, an EMS crew is dispatched to the scene where they meet the patient. In the old model, they treat and transport to the ED.

Now, they have options. The first step is a video telehealth session with a physician. From there, the care choices are:

  • Treat on the scene and release.
  • Transport the patient to an alternate treatment facility, such as a primary care office, urgent care clinic, or community mental health center (CMHC), that functions at a level that is more appropriate for the medical issue in question.
  • Bring the patient to the ED, the same as today.

When transporting patients to the ED, having the right mHealth technology in the ambulance allows EMTs to connect with qualified medical care providers and specialists if the patient’s condition changes. The specialist may be at the hospital, at another site, or even at home; no matter the location, he/she can assess the patient and guide the EMTs in beginning treatment while still en route to the hospital. In severe cases such as heart attack or stroke, starting treatment a few minutes earlier—before arrival at the hospital—can make a dramatic difference between a full recovery, permanent damage, or even death.

The most common example of this en route assessment already in use is telestroke mHealth programs: For stroke victims, the best medication, tissue plasminogen activator (tPA), must be administered within a narrow window of time to be effective and life-saving. Considering that the time lapsed since the stroke’s occurrence may be unknown, those few minutes in the ambulance might present the last opportunity to treat with tPA before that window closes.

In order to be most effective, the consultation between EMTs and specialists must be continuous and reliable as facilitated through the mHealth technology in use, and the cameras and microphones must be able to accurately and precisely relay the patient’s status to the specialist. Enter swyMed and Logitech: Combine swyMed’s mHealth telemedicine software platform, which can maintain a strong, functional signal even in the most remote or network-congested places, with Logitech’s high-definition webcams and video conference cameras, and you have a solution for EMS and their provider/specialist partners to communicate more quickly and effectively than ever before. This ability to collaborate on the move helps establish the best course of action for each patient’s unique situation—and that’s patient-centered care at its finest.

For more information about the ET3 program, visit these sites:
* CMS: ET3 Model
* Carejourney’s analysis of the ET3 model

To read more about how swyMed and Logitech work together to make mHealth faster and more accessible, visit Logitech’s blog post here.

To learn more about swyMed’s Video-Enabled Ambulances equipped with mHealth technology, click here.

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