Mobile Integrated Healthcare: Decreasing Frequent EMS Utilization

Bobby Park, MD Co-Founder & Director of Virtual Healthcare bobby.park@weppa.org

What You ll Learn Today The frequency and financial impact of low acuity 9-1-1 calls on the health care system How can EMS utilize telemedicine to address this issue Why more EMS departments aren t yet utilizing this service Real world examples from RelyMD The potential benefits of community paramedicine paired with virtual health

240 million calls are made to 9-1-1 in the U.S. each year. *The 9-1-1 Association

20%* of 911 calls are considered nonemergencies. *National Association of Emergency Medical Technicians 48,000,000 non-emergency calls per year

The average cost for an ambulance transport is $415.* $19,920,000,000 spent in the US on non-emergency calls That s billion! *Management and Financing of Emergency Medical Services, Todd Hatley, MHA, MBA, EMT-P;P.Daniel Patterson, PhD, MPH, EMT-B

An EMT typically spends 20-30 minutes with a patient depending on their condition, but this could be stretched depending on distance of transport, if needed. 24,000,000 hours per year in the US spent on non-emergency calls

EMS departments in rural areas especially see this.

Why Add Telemedicine? 1. It provides an added medical resource for paramedics to use when appropriate 2. It broadens the scope of care that can be rendered on-scene 3. Decreases number of unnecessary transports 1. Decreased transport times allow EMS units back into circulation faster 2. Improves paramedic morale 1. Improves patient satisfaction 2. Lowers overall healthcare costs for patients and payors

How Does It Work? 1. Ambulance is equipped with computer or mobile device configured for a telemedicine provider.

How Does It Work? 1. Ambulance is equipped with computer or mobile device configured for a telemedicine provider. 2. EMS unit is trained on which conditions are valid for telemedicine use and how to use the platform quickly & efficiently.

How Does It Work? 1. Ambulance is equipped with computer or mobile device configured for a telemedicine provider. 2. EMT team is trained on which conditions are valid for telemedicine use and how to use the platform quickly & efficiently. 3. After hearing the story from paramedics, reviewing VS, and talking to/examining the patient via telemedicine, RelyMD physicians make a medical assessment concerning or non-concerning medical condition. If concerning then recommend transport to ED If non-concerning can come up with alternate treatment plan

How Does It Work? 1. Ambulance is equipped with computer or mobile device configured for a telemedicine provider. 2. EMT team is trained on which conditions are valid for telemedicine use and how to use the platform quickly & efficiently. 3. After reviewing vital signs, obtaining the story from paramedics, and talking/examining the patient via telemedicine, RelyMD physicians make a medical assessment concerning or non-concerning medical condition. If concerning then recommend transport to ED If non-concerning can come up with alternate treatment plan 4. Alternate management plans provide reassurance, education, +/- prescriptions to the patient s preferred pharmacy.

Real World Example: Wake County EMS Pilot 2016 450-person paramedic team Fields roughly 90,000 requests for service per year One of the busiest EMS departments in North Carolina Partners with RelyMD via a 30-day pilot

Real World Example: Wake County EMS Pilot

Real World Example: Wake County EMS Pilot At the end of the 30-day pilot, 18 out of 20 visits that utilized RelyMD avoided transfer to the emergency department. 100% 90% 80% 70% 60% 50% 40% 10 90% 30% 20% 10% 0% Visits That Avoided ED

Real World Example: Wake County EMS Pilot Cost savings from an avoided transport: Ambulance transport fee Emergency Department facility fee ED medical professional fee

Real World Example: Wake County EMS Pilot Cost savings from an avoided transport: Ambulance transport fee $415 Emergency Department facility fee $1,233 ED medical professional fee $250

Real World Example: Wake County EMS Pilot Cost savings from ONE avoided transport: $1,898

Real World Example: Wake County EMS Pilot Cost savings from 18 avoided transports: $34,164

Real World Example: Wake County EMS Pilot $2,467,400 Potential cost savings if 10% of Wake County EMS unnecessary transports avoided.

Real World Example: ETHAN EMS Pilot $11,388,000 Potential cost savings of 6,000 ED transports avoided

Barriers to Entry No funding Telemedicine parity and reimbursement models Cost of entry, depending on service provider Lack of or inconsistent broadband, particularly in rural areas

What is Community Paramedicine Paired with Virtual Health?

Community Paramedicine: An emerging healthcare profession. It allows paramedics and emergency medical technicians (EMTs) to operate in expanded roles to provide routine healthcare services to underserved populations, and helps to improve rural emergency medical services (EMS). Paired with Telemedicine Connects the EMTs with board-certified physicians who are available immediately via video for conditions not treatable by paramedicine alone.

About RelyMD Direct-to-consumer telemedicine service provider started in 2015 Founded and fully staffed by Wake Emergency Physicians, PA (WEPPA) 5 hospital and health system clients, over 60 corporate clients Average utilization rate of 24% compared to the national average of just 5%

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