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The EMS Take: Winter 2022
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The EMS Take with Gary McCarraher
Talking to an EMS leader about telehealth
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I recently sat down with Jonathan Olson of the National EMS Management Association. Jon has more than 30 years of experience in EMS and fire operations. He recently served as interim chair of the FirstNet Authority’s Public Safety Advisory Council (PSAC) and led the PSAC strike team on telehealth. I talked to Jon about his thoughts on telehealth and EMS, the role of technology, and what he sees for the future.
How do you see telehealth being used by EMS?
The basic function of telehealth for an EMS provider is to seek the counsel and advisement of a more senior clinical provider to decide what to do or where to go.
In North Carolina, where I am, we saw use of telehealth with our mental health community when Hurricane Florence approached the coast. The state evacuated several hundred folks to shelters in Wake County. When you get several hundred folks in your shelter, the mental health population can be pretty high. And we used telehealth to do a number of consults.
COVID-19 has affected almost every part of our lives. Has it also affected the use of telehealth?
Once COVID-19 got started people were afraid to call an ambulance. One, they didn't want anybody else in their house, and two, they didn't want to go sit in an emergency department or a waiting room. So things got put off.
Telehealth started to step up and fill in. The patient could talk to the doctor through a device. You can basically have the same conversation you'd have sitting in a doctor's office or in the emergency department. Folks were much more comfortable doing that than actually going somewhere to see a doctor. And folks were comfortable using the same devices they use every day to talk to their parents, children, and friends. It was a very welcome solution.
Speaking of tech solutions, how do you see technology influencing the use of telehealth? How does FirstNet make a difference in telehealth?
The fact that folks are more comfortable using technology is another grand opportunity for us to expand how tech is used in the interface between the general public, first responders, and the rest of the healthcare community, including behavioral health and other specialists.
In the past, we got used to doing more with less in EMS because there wasn't anything else. And now we've created this ecosystem with a network that's accessible. You don’t need a $4,000 piece of hardware on an ambulance to access it. You can access the network from a $199 LTE phone that you could put in the hands of everybody.
We're seeing more telehealth-based applications come out that meet the necessary encryption standards. And I think we're going to see things soon that will allow us to use a Bluetooth biomedical device that allows the doctor to see the electrocardiogram or other biomedical parameters being captured.
You’ve mentioned the importance of incorporating behavioral health into pre-hospital care. Tell us more about that.
We're seeing a lot of patients having a psychological crisis or just a failure to cope. Right now the only thing we can do for them is leave them in an emergency department. We know that's not where they need to be. What can we do to get these folks into a care system much more quickly?
A little more than a decade ago in North Carolina they privatized inpatient behavioral health and closed the state hospitals. Some communities are fortunate to have inpatient behavioral health facilities. But there's still a big part of North Carolina where that's not the case.
We're fortunate here in Wake County that we actually have three different mental health facilities and a mobile crisis team with a behavioral health specialist who functions as a resource within the EMS system. On certain types of incidents, we do the initial assessment with the specialist there. The specialist helps decide if the person needs to go to the E.R., an appointment with a provider, or one of the inpatient facilities.
As we define the way to most appropriately apply health care dollars in a community when it comes to behavioral health, telehealth is one way to get the most bang for your buck.
What do you see as the opportunities and challenges for telehealth and EMS in the future?
I think one of the big challenges is trying to find some way that we can get a conversation started that involves anyone and everyone who needs to be involved in a patient disposition—and that process could benefit from using telehealth. We have grown past the point of just EMS personnel needing to consult with a physician or other advanced clinician and are facing scenarios today that require a broader conversation with the right folks to get the patient to the most appropriate destination. That is the next gap that EMS systems have to fill. We're not inviting all the key people to the table to achieve an effective system. The best lessons are shared lessons, whether successes or failures.
Until recently, the biggest gap was technology, but now technology is an opportunity. I can put a smartphone in your hand and you've got a premiere piece of equipment to participate in telehealth at every step along the way. Plus, we've got a network that will support a connection that's more than enough to work in the telehealth environment.
Telehealth gives us so much opportunity to not only video chat but to share real-time biomedical information. I'm not sure we've got all the people we need at the table yet. And I think that's what we've got to look at in the next 18 to 36 months.
Your experience
What are your agency’s experiences with using telehealth? Send me an email or find me or my colleagues at one of these events:
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We’re celebrating 10 years of FirstNet! The legislation that established the FirstNet Authority and FirstNet was signed into law on February 22, 2012. We made a promise to the public safety community to create a nationwide public safety broadband network. Today we’re delivering on that promise.
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Watch this video to see how the public safety community made FirstNet a reality. Learn about the past decade of massive progress for public safety communications and how the first nationwide public safety broadband network was built and deployed.
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Want to see FirstNet’s unique features in action? Check out these live demos of Z-axis for finding the vertical location of responders and priority and preemption for keeping first responders connected during network congestion.
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Hear stories from public safety leaders in our series From the Command Center. In the first installment, Pete Landon, Director of Homeland Security and Chief of Staff for the Governor of Maryland, talks about advancing public safety communications and tools to first responders.
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New FirstNet Authority Board Chair Steve Benjamin, who is the former mayor of Columbia, South Carolina, joins our podcast to talk about his experience supporting public safety services at the city and state levels as a government leader and his goals for the future of FirstNet.
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Tech, Innovations, and Hot Topics in EMS
Read what we’ve been hearing from public safety in the field about trends and drivers for EMS and emergency communications.*
Winchester, Illinois’s EMS agency is using tech to combat first responder fatigue and staffing issues. After seeing CPR calls triple in 2021, the agency is raising money to purchase two devices that perform high-quality chest compressions, providing EMTs with another set of hands in the ambulance.
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North Carolina’s first responders face a variety of challenges with “communication deserts” throughout the state, especially in rural areas. With a new FirstNet cell tower in Wayne County, first responders will have the coverage they need for emergencies and daily activities.
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Gary McCarraher is serving as the FirstNet Authority EMS Subject Matter Expert. Learn more about Gary or email him with your questions. |
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Top photo: When Mason County, West Virginia needed broadband for their public safety agencies, they considered many options and ultimately decided to go with FirstNet because of coverage. Now all EMS agencies in this rural county use FirstNet for their communications, making a difference for providers and patients alike, especially when ambulance rides can be 45 minutes to the nearest advanced care hospital.
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*FirstNet Authority may provide hyperlinks for third-party, non-governmental websites in order to offer additional context and added value for our users. FirstNet Authority does not endorse any product or service and is not responsible, nor can it guarantee the validity or timeliness of the content on hyperlinks outside of the federal government. In addition, users may wish to review privacy notices on non-government sites since their information collection practices may differ from ours.
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