Five years ago, the Houston Fire Department (HFD) developed the Emergency Telehealth and Navigation (ETHAN) program as a way to respond to every call by providing the appropriate level of health care rather than bringing everyone to the emergency department—without using up resources to transport non-emergency patients. Since its inception, the ETHAN project has picked up a few tips that could prove helpful if your organization is designing, or will design, an emergency telemedicine program.
As explained by Dr. Michael Gonzalez, HFD associate medical director and director of the ETHAN project, ETHAN was originally intended to support clinics, urgent care centers, and ambulances so that specialists may be consulted via telemedicine to determine whether the case constitutes a true emergency. As other clinics—including yours—prepare to make the leap into emergency telemedicine, here are six key takeaways that the ETHAN project managers have learned the hard way; hopefully, these hints can save you some time and effort.
1. Remember that providing patient healthcare is the top priority.
It’s easy to get caught up in the technology and efficiency of telemedicine, but ultimately it’s just a tool. The onus is on the EMTs, nurses, physicians, and other staff to interact with the patients and triage low-acuity cases to more cost-effective providers. When medics respond to a 911 call, connecting with patients in a caring manner helps the medics to educate and direct the patients to the most appropriate branch of the healthcare system for their situations.
2. Internet connectivity is a must-have.
Emergencies often occur in remote locations that lack broadband connectivity and thus cannot support a real-time video call. Even congested areas, such as heavily populated urban neighborhoods, can have the same problem. Systems like swyMed’s DOT Xstream and DOT Backpack are among the rare few that can overcome this connectivity barrier, thus making any emergency telemedicine program feasible.
3. Having the right hardware is critical.
EMTs need rugged, reliable hardware that will connect to the internet when it needs to, that is easy to grab and carry, and that doesn’t have to be constantly recharged.
4. So is the right software.
After all, hardware doesn’t run itself. In a perfect world, the software would need to:
- Function smoothly, dependably and quickly in any environment
- Interface easily with any hardware devices
- Link seamlessly with imaging systems and electronic medical records (EMRs)
- Be simple to operate
- Be HIPAA-compliant
We admit we’re a bit biased, but the closest thing that we’ve ever heard of is our swyMed software platform.
5. Get buy-in from your staff and providers; then train them, from the very start.
Assuming the technology is in place and functional, the providers will make or break your emergency telemedicine program. The staff, medics, and physicians need to be trained in the new methods and protocols, and the physicians need to be available for the incoming emergency calls. At the patient’s site, community medics and local families may have long-standing social or working relationships; medics need to be trained in maintaining patients’ and families’ trust while introducing telemedicine as just another tool.
As Gonzalez revealed, this aspect has proven to be his largest challenge. Thus, he recommends developing an education strategy and a deployment strategy, both of which should target people with various levels of interest ranging from early adopters to the most stubborn skeptics.
6. Build relationships with local providers and taxi services.
Sometimes, after a 911 call response, an EMT needs to schedule an appointment with a nearby clinic or hospital. EMTs can set up the appointment to occur within the next 24 hours so that patients are more likely to comply. If needed, transportation can be arranged as well.
Over time, the data gathered from such an emergency telemedicine program can reveal trends in the community that may affect allocation of budgets and resources. So far, ETHAN has experienced significant success with guiding patients towards the best transport method and most appropriate provider for their situations, leading to the program’s ultimate goal: providing high quality care while reducing inefficient costs.
To learn more about ETHAN and what your organization can learn from their experiences, visit ems1.com here.