This article originally appeared in the Paramedic Chief Digital Edition, 鈥淐are delivery in real-time: Implementing telehealth in EMS.鈥 Download a copy here.
By Michelle Leight
Over the past decade, the U.S. healthcare community has embraced telehealth and leveraged it to enhance quality of care for patients, resulting in improved patient outcomes and reduced barriers to access. While private physicians, clinics and hospitals have integrated telehealth into their processes, EMS has been slower to incorporate telemedicine, citing concerns including background noise, connection errors, difficulty in set-up and use, equipment damage, video quality and interference with patient care.
Due to the global outbreak of COIVD-19 in 2020, health providers at all levels were required to reassess and restructure care delivery for patients. With widespread stay-at-home orders and related medical guidance to quarantine, technology providers rose to the occasion and worked to develop and provide technological advances to solve issues created by the pandemic. As a result, during the initial pandemic surge, telemedicine became a primary treatment modality across the healthcare sector, including the EMS system.
EMS telemedicine introduces numerous benefits for patient care. Most significantly, life-saving treatment delivery can begin immediately and while en route to the hospital based on a remote consultation on a patient鈥檚 condition using audio and visual options that allow a physician to see and speak directly with a patient, and a shared electronic medical record to review vital signs and other presenting factors. Further, with foresight of the incoming medical emergency, the hospital can begin preparing for the patient鈥檚 arrival in support of a seamless transition from the ambulance to the medical facility.
The launch of EMS telemedicine services has expanded EMS providers鈥 role in providing advanced direct medical care to patients in medical crisis. While these changes are beneficial and represent a significant development in healthcare, COVID-19 has impacted already-strained budgets needed to fund telemedicine equipment and training.
Federal grant programs supporting telehealth
Simultaneously recognizing the need for expanded telemedicine and its barriers, the federal government introduced several funding programs to assist agencies in launching telemedicine services, covering costs for equipment, training and other associated expenses. The following to support telemedicine initiatives have been introduced or continued in 2020 and are also funded in the new relief funding for continued financial assistance to eligible providers and activities:
- Originally introduced through the CARES Act with $175 billion in available funding, the new relief package includes an additional $3 billion for healthcare providers to assist with healthcare-related expenses and revenue loss that is attributable to COVID-19
- The CARES Act provided $200 million in funding to the Federal Communications Commission to support healthcare providers in procuring and launching remote telemedicine services, including the purchase of telecommunications devices and information services. The newly approved relief package includes an additional $250 million to support continued efforts.
- The TNGP funds healthcare networks to improve services for medically underserved populations in urban, rural and frontier communities. Specifically, the funding can be used to expand access to, coordinate and improve the quality of healthcare services; improve and expand healthcare provider training; and expand and improve the quality of health information available to healthcare providers, patients and their families.
- The recently approved relief package includes $1.48 billion in funding for firefighters and EMS providers. Funding may be used to develop and launch telemedicine programs to enhance patient care and support low-acuity patients in treating themselves at home, when appropriate, while also decreasing COVID-19 exposure to firefighters, EMTs and paramedics.
- DLT funding is used to enable and improve telemedicine service in rural communities. Funds support the use of telecommunications-enabled information, audio and video equipment, and related advanced technologies that will increase rural access to healthcare resources that might otherwise be unavailable or limited.
In addition to the above-referenced funding programs, EMS providers might also consider state and local government funding opportunities and private donor funding. Many states are partnering with local agencies to sub-award federal funds for eligible uses. In addition, across the U.S., foundation and corporate donors have been incredibly responsive in providing financial assistance. Agencies such as the United Way and local community foundations have developed consolidated giving programs to fairly distribute funding to achieve the greatest impact.
Engaging payers, the medical director, administrators and field providers was key to MedStar's successful telehealth implementation