Prehospital care is initiated and managed unilaterally by local emergency medical service (EMS). The majority of patients, regardless of severity are transported by the most expensive mode of transportation (ambulance) and to the highest cost destination (hospital). Conversely, the CDC views Population Health, as an opportunity to utilize non-traditional partnerships among health care systems, industry, local government, and organizations to work together to improve patient outcomes.
Houston Fire has successfully triaged 31,328 patients by telehealth Emergency Medical Physicians (EMP) and 28,123 (90%) patients were transported via non-ambulance methods from December 2014 through November 2022. Medics complete a patient assessment and transfers the ePCR and contacts the physician, who accesses the patient via real-time video/voice conferencing and determines the appropriate disposition. Once triaged, patient transportation is determined by the physician (taxi, ambulance, self-transport) and destination is decided by patient/physician (clinic, emergency department, home care).
After EMS leaves the scene, ETHAN patients can contact the Nurse Health Line for assistance regarding care, transportation, and destination. Recently, our regional Health Information Exchange began providing blinded managed care indicators to the ETHAN Physicians portal for payor/health plan patient navigation, both supports the CDC Population Health utilization algorithm within the EMP telehealth model.
Learning Objectives:
1. To become familiar with the how ETHAN patients are triaged by emergency physicians for prehospital alternative transportation / destination in a major metropolitan fire-base EMS system.
2. Observe how ETHAN will successfully increase efficiency and reduced cost of emergency care by reducing the utilization of EMS and emergency departments.
3. How the ETHAN program utilizes its partners to increase patient satisfaction and outcomes.