Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments
Introduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models th...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2016-11-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/7gf7h9b6 |
| _version_ | 1818553129492283392 |
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| author | James Robert Langabeer Michael Gonzalez Diaa Alqusairi Tiffany Champagne-Langabeer, Adria Jackson Jennifer Mikhail David Persse |
| author_facet | James Robert Langabeer Michael Gonzalez Diaa Alqusairi Tiffany Champagne-Langabeer, Adria Jackson Jennifer Mikhail David Persse |
| author_sort | James Robert Langabeer |
| collection | DOAJ |
| description | Introduction
Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program.
Methods
The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group.
Results
During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001). EMS productivity (median time from EMS notification to unit back in service) was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median). There were no statistically significant differences in mortality or patient satisfaction.
Conclusion
We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions. |
| first_indexed | 2024-12-12T09:21:55Z |
| format | Article |
| id | doaj.art-133e344f0263490298da41c9b9c64c90 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-12T09:21:55Z |
| publishDate | 2016-11-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-133e344f0263490298da41c9b9c64c902022-12-22T00:29:10ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182016-11-0117671372010.5811/westjem.2016.8.30660Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency DepartmentsJames Robert Langabeer0Michael Gonzalez1Diaa Alqusairi2Tiffany Champagne-Langabeer,3Adria Jackson4Jennifer Mikhail5David Persse6University of Texas Health Science Center, Houston, TXBaylor College of Medicine, Section of Emergency Medicine; Houston Fire Department, Emergency Medical ServicesHouston Fire DepartmentUniversity of Texas School of Biomedical InformaticsHouston Health and Human ServicesUniversity of Texas School of Biomedical InformaticsHouston Fire DepartmentIntroduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001). EMS productivity (median time from EMS notification to unit back in service) was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median). There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.http://escholarship.org/uc/item/7gf7h9b6Emergency Medical ServicesTelehealthComparative Effectiveness |
| spellingShingle | James Robert Langabeer Michael Gonzalez Diaa Alqusairi Tiffany Champagne-Langabeer, Adria Jackson Jennifer Mikhail David Persse Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments Western Journal of Emergency Medicine Emergency Medical Services Telehealth Comparative Effectiveness |
| title | Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments |
| title_full | Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments |
| title_fullStr | Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments |
| title_full_unstemmed | Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments |
| title_short | Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments |
| title_sort | telehealth enabled emergency medical services program reduces ambulance transport to urban emergency departments |
| topic | Emergency Medical Services Telehealth Comparative Effectiveness |
| url | http://escholarship.org/uc/item/7gf7h9b6 |
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