Mobile video pilot aims to reduce ambulance, hospital admission costs

By Judy Mottl

A Michigan healthcare services provider is prepping a mobile video-based health assessment program involving advanced paramedic care in a quest to reduce patient emergency room visits and hospital admissions while also saving on ambulance response costs.

Community EMS, the oldest licensed EMS system in Oakland County, Mich., plans to launch the pilot program on April 14 as part of its emergency response efforts at the Botsford Continuing Care Center in Farmington Hills, a nursing home that is one of several medical facilities under the Botsford Health Care corporate umbrella. The mobile telemedicine approach is focused on improving patient care while avoiding unnecessary hospital emergency trips, Sanford Vieder (pictured), Botsford's emergency room director, told FierceMobileHealthcare.

"The premise is that many trips to the ER aren't necessary and many times a patients can be treated at the nursing home which is much better for patients," Vieder said. He described the mobile technology as a "new paradigm" in treating nursing home patients.

"If they have a medical problem, they frequently get put into an ambulance, brought to a chaotic ER, treated, then sent back to the nursing home," Vieder said. "The benefit [with the video paramedic system] is not pulling them away from a comfortable environment they are in unless they have a real medical emergency."

The program comes at a time when healthcare professionals, payers, hospitals and consumers are striving to save on medical costs by tapping emerging technologies that also promise to enhance patient care from diagnosis to treatment.

Community EMS believes the technology will provide considerable savings for ambulatory service providers as the cost of an ambulance trip to a hospital runs about $3,700.

When a nursing home patient requires medical help, a nurse will call a special phone number to talk with an ER physician to determine if the patient needs to be taken to a hospital or is a candidate for the video paramedic response program, Vieder said. The pilot will take place over several months and involve a minimum of 64 patient interactions, he said.

"We go through a series of questions and determine if a patient is a candidate. If we don't think so, 9-1-1 is called and the patient is taken to the hospital."

If the patient's situation appears to be one that can be treated by the specially-trained paramedics, CEMS sends out a response team trained in using the video system via a medical vehicle, not an ambulance.

The mobile video system lets ER healthcare providers remotely monitor a patient's vital signs including heart, lung and blood functions for patients suffering from congestive heart failure, diabetes and dermatology issues. The system uses high-definition cameras and two-way audio systems. It integrates all vitals like blood pressure, electrocardiogram, pulse oxymetry, weight/body mass index, blood glucose, and spirometry plus diagnostic tools like ultra-sound systems.

The paramedics, working with an ER physician via a video booth system at the hospital, treat the patient at the nursing home.

"We're able to deliver the healthcare service needed at half the cost," Vieder said, adding that another top goal is to convince federal medical agencies, such as Medicare and Medicaid, to support such telemedicine services. Currently those agencies, as well as some large healthcare payers, won't pay for such services.

"This will provide the needed evidence that these services should be supported given the cost savings," Vieder said. He added that CEMS currently is funding the pilot program, which involves providing tech training for nurses, paramedics and ER doctors, though he hopes to get a grant.

Vieder believes such telemedicine approaches have big potential outside nursing home healthcare response, noting it would be a boon to prison facilities and house-call medical ambulatory services.

"We believe in this model and that it just makes a ton of sense given the benefits," Vieder said.

As FierceMobileHealthcare reported last week, as part of a new free telemedicine program aimed at reducing costs, boosting improving patient care and luring new clients, two Kaiser Permanente doctors are treating patients using video conferencing.

For more details:
- learn more about Community EMS

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