A new startup in Pasadena is seeking to add telehealth services to emergency ambulance responses, which it says will prevent countless unnecessary and expensive trips to emergency rooms.
Eighty-five percent of people taken to emergency treatment centers by ambulance in the U.S. each year could be treated in home or clinic settings, said Tele911 co-founder and CEO Dr. Marc Eckstein.
With emergency facilities currently being the only option for many U.S. ambulance and emergency medical service providers, the end result is roughly 18 million unnecessary emergency room transports each year, costing an estimated $32 billion, he said.
Eckstein is a professor of Emergency Medicine at USC’s Keck School of Medicine and also is the Commander of the Los Angeles Fire Department’s Emergency Management Services.
Tele911 aims to provide emergency responders with quick access to skilled doctors via telehealth, giving them a wider range of options for treatment.
“We integrate telemedicine to have experienced emergency physicians supplement the evaluation by paramedics who are on scene to determine if indeed the patient can safely be treated at home or can go to an alternative destination as opposed to automatically being transported to an emergency department,” Eckstein said.
“On the other end, we know there are patients who currently call 911 and aren’t transported that have some subtle findings that might have been missed. That would be much more likely to be picked up by an emergency physician,” he added.
“So to be able to leverage innovation and technology, to bring an emergency physician virtually to the patient’s living room to further assist the paramedics, to make a safe patient disposition, obviously, is patient-centered and improves patient safety and literally as an opportunity to save billions of dollars to the system and also for the patient because patients have copays and deductibles.”
The business is made possible by a recent change to federal law called the Emergency Triage, Treat, and Transport, or ET3, model.
“The crux of this concept is: Previous to ET3, there was a built-in financial incentive that whoever calls 911 gets transported to the emergency department, because if you don’t transport, you don’t get paid,” Eckstein said. “The only reimbursement at EMS was ambulance transport for an emergency department. It’s very expensive to have a system of professionals respond 24/7, 365 and get to your home in five or 10 minutes.”
“If you, if you could incorporate a telemedicine program, like the one we’re talking about with Tele911, or transport these patients, not to an emergency department, but to an alternate destination, such as an urgent care clinic or a doctor’s office, EMS will pay the ambulance provider or the fire department or the city the same amount they’re paying now for ambulance transport to an emergency department,” he said. “Meaning it’s revenue-neutral for the ambulance provider or the city, but the government saves all the costs they would incur had they never gone to an emergency department. So that paradigm is the key catalyst.”
Paramedics are able to perform a preliminary examination and immediately provide all pertinent data to doctors via mobile device. Armed with that information, the doctors can then perform a remote evaluation and determine the best course of action.
“If the patient can be safely treated in place, the paramedics are released,” Eckstein said. “They go available from the scene rather than transporting. Then, they’re available for the next call, which may be a life-threatening call,” he said. “Our physician then calls back the patient after the paramedics have gone available. They will basically text the patient a link for their aftercare instructions.”
The system is also able to help coordinate with patients’ insurance providers to schedule follow-up clinic appointments, he added.
“We want highly trained paramedics to be available to respond to life-threatening calls in a timely manner,” Eckstein said. “But when they’re transporting low-acuity patients all day long, and that’s the majority of their patients, it’s unsustainable from a systems perspective, from an economic perspective. And ultimately it compromises response times and compromises lives.”
More information on Tele911 is available on the company’s website at tele911.com.