TELEMEDICINE IN EMS

Kyle R. Gorman, MBA, CMOD

Clackamas Fire District 1Clackamas County, OR

WHY TELEMEDICINE IN EMS?

• Medical Complexity• Prevention• Reducing readmissions• Rural access, including

correction facilities• Video documentation of

scenes to improve medical decision-making.

• Disaster medicine• Accuracy

WHY NOW IS THE TIME

• This is not a new idea. • Convergence of

technology--telemedicine and videoconferencing.

• Smaller and more powerful mobile devices,

• Widespread wireless broadband mobile data,

• An emphasis on healthcare cost reduction,

• Documentation of improved quality and patient satisfaction.

TYPICAL PROGRAM GOALS

• Maximize quality• Reduce costs• Improve patient safety• Improve decision making• Reach the medically underserved—rural areas,

incarcerated patients, wilderness misadventures• Improve resource availability by reducing high

utilizers.

IS IT WORTH IT?

Financial Benefits

• Reduce transports• Reduce admissions• Free-up resources• Reduce wait times• Improved quality• Reduce costs and• Improve access to

medically underserved

The 7 Deadly Wastes

• Overproduction• Inefficient Transport

(all transport is waste!)• Unnecessary Motion• Waiting Times• Poor Quality• Inappropriate

Processing• Unnecessary Inventory

BARRIERS TO IMPLEMENTATION

• Getting over the “Telemedicine Funding” issue• Certification—will additional be needed?• Scopes of practice• Paucity of evidence-based research • Integrating data• Patient tracking (without confusing patients)

WHO’S USING THE TECHNOLOGY?

United States Government

• Military—especially forward outposts• NASA• Remote outposts—

Dr. Jerri Nielson (Antarctica)

WHO’S USING THE TECHNOLOGY?

E. Baton Rouge Parish, Louisiana

• Used primarily to prevent hospital readmissions

• COPD patients, diabetics and substance abusers

• Moving toward pediatric asthmatics and corrections patients

WHO’S USING THE TECHNOLOGY?

Liberty County, Texas

• Used DREAMS Ambulance in Katrina• Dr. “Red” Dukes• Contributed to PA

assistance during complex hand surgery.

• Others in disaster medicine:• Loma Linda University

THANK YOU!

• For more information:

Kyle R. Gorman, MBA, CMODClackamas Fire District 1gormankyle@comcast.net(503) 939-8664