New hi-tech program helps to curb unnecessary ambulance rides
HOUSTON – Houston paramedics and EMTs receive between 700-800 calls for help every day, but among the shootings, stabbings, heart attacks and strokes are those who abuse the 911 system.
"We get called for people with blisters on their feet," said Houston Fire Department Senior Capt. Andrew Moore. "Honest to God, you know, I've been called for paper cuts."
Moore said these type of repetitive calls for non-emergencies is a leading reason for burnout among paramedics and EMTs.
"That's the most frustrating thing my medics have to deal with," said Moore. "They're just worn out getting called by folks that don't understand or the folks that do understand and don't care."
"Do you think there are people who use you guys as a free taxi service and don't really understand what the point of 911 is?" asked Local 2 investigator Robert Arnold.
"Absolutely, that happens every day," said Moore. "I was called for a guy that walked through tall grass and then called me out to see if he had been bitten by a snake because had heard snakes were in tall grass."
City EMS officials, citing a recent study by the School of Public Health at the University of Texas Health Science Center in Houston, estimate that 30-40 percent of 911 calls for medical help do not involve true emergencies that require a trip to the emergency room, yet city officials said about half of all calls for help result in a person being transported to an emergency room by ambulance. Paramedics and EMTs cannot refuse to transport someone to the hospital.
The starting cost of a city of Houston ambulance ride is $1,000. Currently, the city of Houston is owed approximately $300 million in unpaid ambulance bills. The price tag is comprised of people who truly needed help and cannot afford to pay the bill, plus those who dial 911 when it's really not an emergency.
City of Houston Medical Director Dr. David Persse said many of the people who dial 911 for non-emergencies do so because they do need some type of medical care, but they don't know how to access the system without dialing 911.
"They just don't know how to get the health care or the help they need so they resort to calling 911 because they don't know what else to do," said Persse. "That's the most expensive form of transportation to the most expensive form of unscheduled healthcare and there's got to be a better way."
Persse said the city believes it has found that better way through a new program called the ETHAN project, or Emergency TeleHealth And Navigation.
The city's associate medical director, Dr. Michael Gonzalez, explained the goal will be to have every fire truck and ambulance in the city carry tablets that have cameras which can be used to help evaluate patients in the field to help them access healthcare in a more efficient way.
Gonzalez said the city will hire currently practicing emergency room physicians with a minimum of five years experience to be part of the ETHAN project. These physicians will sit in the dispatch center and help paramedics, EMTs and firefighters evaluate the needs of people who dial 911, but aren't necessarily having a medical emergency that requires a trip to the ER.
"It's going to be the physician interviewing the patient the same way they would in the emergency department," said Persse.
Persse said via the cameras a doctor can have a thorough discussion with a patient, see a patient's physical condition and instruct the paramedic, EMT or firefighter in the field to perform certain tasks to help evaluate the severity of a person's medical complaint. Persse said if the doctor determines the person is not having a medical emergency then they will use GPS to find a clinic closest to the patient, schedule an appointment for them and arrange for non-emergency transport.
Persse said this will help cut down on costly ambulance rides and trips to the ER.
"Many times we'll be able to schedule an appointment the same day the patient called 911," said Persse. "Plus, this way the person can get in to see a doctor faster than if they had gone to the ER and had to sit in a waiting room for hours."
Houston is the first city in the country to implement this type of program and it is being funded through a federal waiver program. Section 1115 of the Social Security Act gives the government the authority to help fund municipal programs that are using "innovative service delivery systems that improve care, increase efficiency and reduce costs."
Persse said the city will be rolling out the program this summer and have it implemented citywide by September. The city plans to hire 30 ER physicians who will work in shifts every day of the year. Gonzalez estimates it will cost $800,000 to pay for the cost of the physicians and another $250,000 to build ETHAN work stations in the dispatch center.
Prior to this project the City of Houston Health Department was already working to cut down on the problem of people frequently dialing 911 for non-emergencies. Persse said when the city identified a so-called "frequent flyer" -- someone who dialed 911 more than three times in three months -- then health and social workers would be sent to their home to help determine what services they needed to address their medical conditions.
Persse said this program has already been successful in cutting down the number of repeated unnecessary 911 calls for medical help.
Zip codes that generated the highest number of 911 calls:
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