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Barriers to Effective Communication II01:21

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The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
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Types of Reports III: Telephone and Verbal Reports01:26

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TeleEMS: An EMS Telemedicine Pilot Program Barriers to Implementation.

Lindsay R Jaeger1, Michael P McCartin2, Ameera Haamid2

  • 1Pediatric Emergency Medicine, University of Chicago Comer Children's Hospital, Chicago, Illinois.

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Summary
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Implementing telemedicine in emergency medical services (EMS) allows for treatment in place for low-acuity 9-1-1 calls. Addressing barriers like technology and patient expectations is key for successful EMS telemedicine programs.

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Area of Science:

  • Emergency medicine
  • Telehealth
  • Health services research

Background:

  • The COVID-19 pandemic highlighted the need for innovative emergency medical services (EMS) and hospital programs.
  • The Emergency Triage, Treatment, and Transport (ET3) model offers flexible payment for Medicare beneficiaries using alternate care strategies.
  • Treatment in place via telehealth after a 9-1-1 call and ambulance response is a key component of ET3.

Purpose of the Study:

  • To evaluate the implementation barriers of a telemedicine service for 9-1-1 responding ambulances.
  • To assess the feasibility of providing treatment in place for low-acuity conditions using telehealth.

Main Methods:

  • A pilot TeleEMS program was implemented in a large, urban fire-based EMS system.
  • Paramedics utilized HIPAA-compliant telemedicine software for real-time audio-video communication with emergency physicians.
  • Screening criteria included age (1-70) and vital sign parameters, excluding pregnant, combative, or non-emergency patients.

Main Results:

  • Seven out of thirteen consults resulted in successful treatment in place.
  • One consult led to emergency department transport, and five attempts failed due to technological issues.
  • Key barriers identified included paramedic buy-in, patient expectations, technology limitations, and physician availability.

Conclusions:

  • EMS telemedicine programs can be successfully implemented in urban settings for 9-1-1 responding ambulances.
  • Addressing implementation barriers at the paramedic, patient, technology, and program levels is crucial for program success.