Pulsara Blog

EDITOR'S NOTE: The following is an excerpt from an article by Larry Beresford, originally published on EMS World on April 3rd, 2024. Check out the full article here. 

Telemedicine for the EMS personnel of MedStar Mobile Healthcare, a governmental EMS system in Fort Worth, Texas, is linked through an app on their Android hand-held phones, says Matt Zavadsky, MS-HSA, NREMT, MedStar’s chief transformation officer.

“The crew does everything with their Android phone. They get their calls and their post moves, they get routed by the live routing system, they text with dispatch, they text with each other,” Zavadsky explains. “When they get to the scene of a call, they pop the phone out of its drop-in cradle charger at the front of the truck and bring it with them.”

Telemedicine, which can connect them virtually with physicians from integrative emergency services and the physician with the patient, has been a positive experience for MedStar’s field staff, Zavadsky says. “Every EMT or paramedic who works out in the field knows that a fair percentage, some might say the majority, of our patients, don’t actually need to go to the emergency room.” Is it safe for this patient to go to urgent care? Can they get a prescription written for a new medicine or refill an existing prescription?

A virtual physician visit can answer these questions, and having that telemedicine backup facilitates the paramedics and EMTs to provide more patient-centric care, says Zavadsky, who also takes occasional EMT shifts himself. “We are helping the patient navigate the health care system to the most appropriate setting. One of the tools we use is telemedicine, just like we use a 12-lead EKG monitor.”

EDITOR'S NOTE: This article originally appeared on FireRescue1.com. Special thanks to our guest author, Courtney Levin, for FireRescue1 BrandFocus Staff.

Departments can play a large role in supporting the health and safety of underserved residents

The inherent nature of the fire service means that responses to community needs are usually reactive. Whether a 911 call is for a fire, a serious vehicle collision, or a medical emergency at someone’s home, firefighters can’t predict ahead of time where these instances will occur.

That’s not to say the fire service hasn’t made great strides to be proactive about their day-to-day operations when and where they can. For example, departments routinely engage in fire inspections to bolster the safety of local buildings. After all, reducing the likelihood of a fire starting is certainly a more preventative route to take than fighting a fire once it’s begun.

Proactivity isn’t limited to structure fires, though. Fire departments can also apply this line of thinking to the individual residents in their community by developing a community paramedicine program.

[While we are using the term “community paramedicine” for simplicity, there are other similar terms, including “mobile integrated health” and “community integrated health.”]

Many EMS agencies across the country already engage in community paramedicine programs, and the fire service can and should play an important role in those programs. Whether your area already has this type of care in place or not, there’s always an opportunity to provide greater support for the underserved residents in your community.

Prior to the COVID-19 pandemic, Teller County, Colorado, had a successful community paramedicine program in place. But as the pandemic hit the U.S., they knew they'd need to leverage new tools to continue treating their patients. Fire and EMS leaders partnered with Pulsara to enhance their community paramedicine program with telehealth. Since then, the program has evolved into a thriving partnership between EMS and a local organization of board-certified emergency physicians, allowing them to work together via telehealth to help address healthcare disparities and improve access to care in rural areas.

In a recent webinar, EMS leadership in Teller County, Colorado, shared their experiences around building the program, and how they are using telehealth as a force multiplier to preserve resources while also better meeting the needs of their community. Here are 7 top takeaways from their experience. 

Prior to the COVID-19 pandemic, Teller County, Colorado, had a successful community paramedicine program in place. But as the pandemic hit the U.S., they knew they'd need to leverage new tools to continue treating their patients. Fire and EMS leaders partnered with Pulsara to enhance their community paramedicine program with telehealth. Since then, the program has evolved into a thriving partnership between EMS and a local organization of board-certified emergency physicians, allowing them to work together via telehealth to help address healthcare disparities and improve access to care in rural areas.

In a recent webinar, Dr. Jeremy DeWall, EMS Medical Director at UCHealth Pike's Peak Regional Hospital, and James McLaughlin, Director of Community Paramedicine at Ute Pass Regional Health Service District, shared about their experience with building the program, and how they are using telehealth as a force multiplier to preserve EMS resources while also better meeting the needs of their community. 

Editor’s Update: As reported by JEMS.com on 6/28/23, the federal government is ending the ET3 program. According to the Centers for Medicare & Medicaid Services, “This decision does not affect Model Participants’ participation in the Model through December 31, 2023.” Read the full article on JEMS for more details: ET3 Program Comes to an Abrupt End. Please be advised that Mobile Integrated Healthcare and Community Paramedicine are separate initiatives and are unaffected by the ET3 program termination.

__

When the COVID-19 pandemic first surged across the U.S., it created many new problems for EMS organizations everywhere. Some patients infected with COVID-19 urgently needed care at the hospital, while others were best served by staying home. It was difficult to tell which was which. Patients with other ailments were stuck at home, unable to receive regular needed medical care. And on top of that, the pandemic was a major provider safety issue; medics and hospital staff put their lives on the line daily to care for patients, constantly risking exposure to the virus.

Austin-Travis County EMS (ATCEMS) based in Austin, Texas, knew they needed to deploy an innovative solution, and fast. They responded by forming what came to be known as the C4 unit: the Collaborative Care Communication Center.

The C4 is an elite team of twelve EMS-trained clinicians who manage calls and connect patients with a variety of resources. At the start of the pandemic, they began using Pulsara, a healthcare communication, telehealth, and logistics platform, to build better communication with their teams. Through Pulsara, they sent alerts to the hospital about crews bringing in COVID-19 patients, giving hospital staff more time to prepare. And since the providers on-scene wore heavy PPE, making it difficult to communicate verbally, the C4 was able to use Pulsara to facilitate communication for them and manage the case remotely.

But as the pandemic evolved, so did the challenges faced by healthcare providers. By the time ATCEMS was facing its third wave of the pandemic in August 2021, local hospitals were maxing out capacity and lacked both the beds and the bandwidth to care for every patient that came through their doors. ATCEMS knew they needed a way to reduce the burden on emergency departments.

The past two years have done a great deal to redefine the shifting identity of EMS. COVID-19 changed a lot about how we provide care, and some of the solutions we came up with have led to a watershed of self-discovery. With that, though, comes an equal number of questions. What does the shifting landscape of healthcare mean for EMS? What will the role of EMS be going forward? As the identity of EMS evolves and medics are given more agency, will they be able to help find solutions for problems like overcrowded emergency departments, while also giving patients both a better and more appropriate care experience? 

Corey Ricketson, Pulsara's Vice President of Strategic Accounts, recently had the opportunity to discuss these and other hot topics in EMS with Chris Cebollero on The Inside EMS podcast, hosted by EMS1. Corey shares his experiences visiting multiple EMS agencies throughout the country, as well as some top takeaways from how leading EMS agencies are finding solutions to issues like ED overcrowding. Chris and Corey talk community paramedicine, how EMS needs to adapt for the future, the importance of meeting patients where they are, and how interoperability, connection, and communication should be a main focus for EMS agencies.

Listen to the podcast below, and read on for part 2 of the interview! (If you missed part 1, check it out here.)

The past two years have done a great deal to redefine the shifting identity of EMS. COVID-19 changed a lot about how we provide care, and some of the solutions we came up with have led to a watershed of self-discovery. With that, though, comes an equal number of questions. What does the shifting landscape of healthcare mean for EMS? What will the role of EMS be going forward? As the identity of EMS evolves and medics are given more agency, will they be able to help find solutions for problems like overcrowded emergency departments, while also giving patients both a better and more appropriate care experience? 

Corey Ricketson, Pulsara's Vice President of Strategic Accounts, recently had the opportunity to discuss these and other hot topics in EMS with Chris Cebollero on The Inside EMS podcast, hosted by EMS1. Corey shares his experiences visiting multiple EMS agencies throughout the country, as well as some top takeaways from how leading EMS agencies are finding solutions to issues like ED overcrowding. Chris and Corey talk community paramedicine, how EMS needs to adapt for the future, the importance of meeting patients where they are, and how interoperability, connection, and communication should be a main focus for EMS agencies.

Listen to the podcast below, and read on for part 1 of the full interview! 

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, Sarah Calams of EMS1 Frontline Voices. 

__

Community paramedics are pioneering new ways to care for mental health patients – here’s how

Since the COVID-19 pandemic, EMS providers have seen an alarming uptick in patients refusing to go to their doctor’s office or the emergency room. Many others – including those with urgent conditions – have even been hesitant to call 911.

“We saw patients who were just foregoing all of their medical care – they were ignoring their emergency conditions,” said James McLaughlin, director of the community paramedicine program at Ute Pass Regional Health Service District in Woodland Park, Colorado.

To ease his community’s fears, McLaughlin introduced a new Healthcare Options Mobility and Engagement, or HOME, program, which pairs an in-home paramedic visit with a telehealth consult by a physician – like Dr. Jeremy DeWall, EMS medical director at Ute Pass Regional Health Service District.

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author,  Marianne Meyers, BS, for EMS1 BrandFocus. 

EDITOR'S UPDATE: The ET3 program is mentioned throughout the below article. Please note that, as reported by JEMS.com on 6/28/23, the federal government is ending the ET3 program. According to the Centers for Medicare & Medicaid Services, “This decision does not affect Model Participants’ participation in the Model through December 31, 2023.” Read the full article on JEMS for more details: ET3 Program Comes to an Abrupt End. Be advised that Mobile Integrated Healthcare and Community Paramedicine are separate initiatives and are unaffected by the ET3 program termination.

Wow! Was 2020 a doozie or what? COVID-19 took a toll on our healthcare system, resources, economy, and the way we do business. We survived rolling epicenters of virus surge on a national scale. Needless to say, it’s been a chaotic year. 

Emergency Medical Services—EMS, for short—is a branch of healthcare, public health, and public safety that responds to calls for help, 24/7, in almost every community in our nation. EMS encompasses a number of different services and roles, providing vital lifesaving care for patients during times of emergency. There are around 1.05 million licensed EMS professionals across the U.S. and nearly 623,000 of these are EMTs, while over 268,000 are paramedics. 

In the largest pandemic of our lifetime, learn how clinical leaders in Colorado Springs, CO, are using mobile technology to not only manage the COVID-19 crisis, but also lay the foundation for the new reality of EMS, including 911-initiated telemedicine, Mobile Integrated Healthcare, Community Paramedicine, and telehealth. For the first time ever, the presenters will outline their modernized management system and share case studies and key takeaways that will help you improve patient care, upgrade team communication, reduce cost of care, and increase EMS agency and hospital revenue. Clinicians and thought leaders are creating a new path forward, based around the HIPAA-compliant, secure, mobile-first telehealth communication platform Pulsara.

What: 911-Initiated Telemedicine: How Colorado Springs, CO, Clinical Leaders Are Revolutionizing Emergency Medicine via Mobile Technology

When: Tuesday, Sept 8, 2020 | 1:00 pm EST /  12:00 pm CT / 11:00 am MT / 10:00 am PT

How: SIGN UP HERE

Keep reading to learn more!

EDITOR'S NOTE: Last month, EMS1, Fitch & Associates, and the National EMS Management Association released their third annual EMS Trend Report, proudly sponsored by Pulsara. Because the articles and advice found within contain such critical subject matter, we've elected to publish each segment one at a time here on our blog. Read, enjoy, share, and take to heart the following information brought to you by the most prestigious thought leaders in EMS.

About the authors: Jay Fitch, PhD, is a founding partner of Fitch & Associates and is internationally recognized for leadership as a consultant, educator and innovator in EMS and public safety.

Anthony Minge, EdD, is a senior partner at Fitch & Associates. Prior to joining the firm, he was the business manager for Northwest MedStar in Spokane, Washington.

TECHNOLOGY ADOPTION, PROVIDER RESILIENCY AND PREPAREDNESS: INTERPRETING THE EMS TREND REPORT 2020

EMS leaders anticipated a linear progression in 2020 – managing a slight increase in call volume and reimbursement, while trying to become more efficient and otherwise hold down costs. COVID-19 certainly changed the definition of normal, and perhaps how EMS will evolve in the future.

The EMS Trend Report asks a number of questions each year to ascertain industry perception of a wide variety of key issues and related trends, from measures used to track cardiac arrests, to clinical interventions, ePCR satisfaction, use of lights and sirens for 911 responses, budget changes, and the degree to which agencies are prepared for disruptive events.

GROWING UP IS HARD.

As a young industry, EMS had its cute years. We were the baby of the family. Our oldest brother, Police, followed Mom and Dad’s orders to a T. Police was a rule-following perfectionist who aimed to please. Then, there was the middle child, Firefighter. She was similar to her brother, following in his footsteps and enjoying the attention of being the baby of the family ... until we came along. Then, she started taking on a new role – differentiating herself from her older brother while at the same time, nurturing us.

Learn how communities across the country are leveraging community paramedicine and mobile integrated health for better patient care.