Telemedicine to link Bloomfield EMS with St Joe’s

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Bloomfield Township’s 57 firefighters are also trained as paramedics.

They will be part of a pilot program to use secure tablets while on their runs for real-time advice.

The tablets will link the paramedics to St. Joseph Mercy Oakland emergency room doctors.

The goal is to provide care while reducing unnecessary re-admissions to the hospital.

  As the chief of the emergency department at St. Joseph Mercy Oakland, Dr. Mary Jo Malafa knows that when it comes to providing care, sometimes all it takes is just being there.

“Sometimes you just need to eyeball a patient to see what is going on,” she said.

Soon, Malafa and the rest of her staff in the ER at the Pontiac hospital will be able to do that for patients in Bloomfield Hills, without them ever having to leave their homes.

The hospital is partnering with the Bloomfield Township Fire Department to train the 57 firefighters, who are also certified paramedics, on how to use tablet devices to connect with emergency room doctors in real-time on their runs. The training begins in May.

“A lot of these people don’t want to have to come to the hospital. This allows us to give them that care at their home,” said Dennis Fecteau, the operations officer for the fire department and one of the emergency responders who will be taking part in the pilot program. “We’re the eyes, ears and hands of the doctor, through the screen.”

Bloomfield Township is the first municipality to participate in such a program, which is the latest in St. Joseph’s mutli-year strategy for implementing telemedicine.

Telemedicine has a wide definition and can include everything from phone applications that allow a patient to check their test results online, to texting or emailing doctors, to actually using a tablet, phone or computer to talk in real-time with a physician. Within a hospital setting, telemedicine allows doctors to work together over these devices and make diagnoses without actually having to be in the room.

How it works

In the case of this program, it would work like this: The paramedics would arrive to either perform scheduled welfare visits for recently released patients or respond to emergency calls. They would assess whether the person needs to be taken to the hospital immediately. If not, they can reach out via the security-enabled tablet to an emergency room physician for an opinion. Aside from the visual on the tablet’s camera, the paramedics’ tools can be hooked up to deliver real-time pictures of, for example, the patient’s throat, nose or ears.

It’s a supplement to care, not a substitute, says Dr. Fabian Fregoli, vice president of quality and patient safety at St. Joseph.

“Paramedical professionals have the skills and the mobility,” said Fregoli. “And with the support of emergency room physicians and appropriate technology, they can identify if the patients need early intervention to prevent a bounce back.”

The field of telemedicine isn’t new. It’s been especially popular in rural areas. But it’s gotten a major push from the new health care laws.

Under the Affordable Care Act, hospitals are now being penalized if they have re-admissions within 30 days. The partnership is designed to reduce unnecessary re-admissions while making sure patients get the care they need, says Jack Weiner, president and CEO of St. Joseph Mercy Oakland.

“It’s become an area of innovation and research,” said Weiner. “It was a natural to begin with Bloomfield because they wanted to enhance their visibility in the community between their runs, and we wanted to make sure they had the resources to do this.”

St. Joseph Mercy Oakland has already had a telemedicine strategy in place since October 2006, when the hospital became a hub for the Michigan Stroke Network. Through the program, doctors in 21 hospitals across the southeast and middle of the state can have real-time access to stroke specialists. Last year the hospital also launched MDLive, a system that provides patients with virtual appointments with doctors 24/7 using the same kind of real-time tools.

This type of technology is becoming more popular and growing in use across the country as state legislatures enact laws to keep up with the advances. Michigan is one of 20 states that has enacted parity laws requiring insurers to cover telehealth services. Another six states have bills in their state legislatures.

One of the biggest barriers to entry is that Medicare and Medicaid still aren’t guaranteed to cover the costs, but that could change as more people are exposed to the technology, says Jonathan Linkous, CEO of the Washington, D.C.-based American Telemedicine Association.

“Consumers are right on the edge of starting to demand it,” said Linkous. “Once you start using it, you’ll never go back. It’s so much more convenient.”

According to a January outlook report from the American Hospital Association, use of telemedicine services will continue to grow, from an estimated 250,000 patients served in 2013 to 3.2 million in 2018.

St. Joseph’s and Bloomfield Township are still working out the program’s logistics. Tablets will be supplied by the hospital. Data gleaned from the pilot program will be reported back to the state.

It’s hoped this will lead to a much more expansive program that leverages the technology now available.

“We have very talented paramedical professionals who can provide great services to patients and have the mobility to go to them,” Fregoli. “We have the expertise on our end and when you combine the two, it just makes sense.”

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