App can allow 911 callers to avoid hospital trip
The San Antonio Fire Department is conducting a pilot program that allows a paramedic to talk to a 911 caller with mild injuries via video chat instead of having an ambulance sent out every time.
“In the past, we were sending firetrucks and ambulances to calls where citizens may not need any additional care, they may not need to go to the hospital, but we had no way to have the technology to look into what’s going on in that situation,” Fire Chief Charles Hood said.
The program not only saves the department’s 35 full-time ambulances for more severe situations but also reduces costs for the patient.
“I can’t tell you how excited I am about this piece of technology,” Hood said. “This is going to save us as far as our exposure to the public, as far as dealing with additional PPE (personal protective equipment), dealing with traffic, response times and overloading the hospitals.”
The Fire Department began piloting the GoodSAM program Oct. 19. For three weeks, the department had 16,348 calls. Of those, the program was used for 392 that were deemed low acuity, or calls for less severe injuries such as cutting a finger or stubbing a toe. And of those 392, 247 did not end up needing an ambulance or other in-person medical attention from the department.
The 247 account for roughly 1.5 percent of total calls in those three weeks but saved resources for 60 percent of those mild calls to go toward more life-threatening cases, officials said.
And it can help the patient’s pocketbook, too. The average charge for transporting a patient by ambulance is a little more than $1,100, according to the city’s website.
If EMS personnel are called out to do a medical assessment, even if the patient isn’t transported, the patient is still charged more than $100 on average.
However, if a patient is helped using telemedicine via the app, they will not incur any charge, according to Joe Arrington, Fire Department spokesman.
But before a patient can be helped with the GOODSAM app, dispatchers have to make sure they aren’t in a life-threatening situation.
When the Fire Department gets a call, a dispatcher first verifies the patient’s phone and address. The dispatcher then goes through protocol written by the Office of the Medical Director. Callers complaining of serious problems — such as a major car accident or potential heart attack — have an ambulance sent to their location while the dispatcher is still on the phone.
Callers with milder complaints will be asked further questions. If that person is identified as having a low-priority incident, the person is transferred to a clinical dispatcher who will verify that there are no critical signs or symptoms.
Meanwhile, the initial dispatcher will be freed up to take other calls.
If the situation seems appropriate for telemedicine, and if the patient has access to a smartphone, the clinical dispatcher will send a link via text or email to the caller for the GOODSAM program. Once clicking on that link, the patient will be directed to a browser version. No downloads are required.
The patient will be asked to give audio and video permissions for the call, which allows the dispatcher to interact with the caller, see the injury, assess the person’s ability to follow commands and even get the caller’s pulse rate using the phone’s artificial intelligence.
The dispatcher can then determine if the patient needs any resources, or if at-home care is appropriate, if available. The dispatcher can also send a taxi voucher if an ambulance isn’t necessary but the patient should go to an emergency room or a clinic.
The Fire Department is the first agency in the U.S. to test this app, but it has been used in the U.K., Australia and New Zealand.
Currently, the department has only one clinical dispatcher, but it plans to ask the City Council for $145,000 next week to expand the program, including hiring more clinical dispatchers.