For the past two years, paramedics in the Houston Fire Department have been using telehealth and electronic health record technology to remotely consult with physicians via iPads when responding to calls to patient homes.

Many times, paramedics respond but find they’re not facing an urgent emergency, but the patient may still be best served by being transported to the emergency department. Or perhaps the best route would be to pay the taxi bill to send the patient to a community health center where they can establish a medical home.

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Remote consultation with a physician helps make the right decision, says James Langabeer, a professor of clinical informatics at the University of Texas who oversees the program along with Michael Gonzalez, MD, deputy medical director at the fire department and an assistant professor at Baylor College of Medicine.

The program, Langabeer and Gonzalez will explain during a session at HIMSS17, is designed to reduce ambulance transport to the hospital, saving money and having more resources available when actual urgent emergencies arise. In essence, Langabeer says, the combination of telehealth consultations and EMS services is providing a certain level of primary care.

To date, the program has not used health information exchange technology because the level of HIE in the region is not conducive to urgent communications. But as HIE expands, it could give paramedics more information on patient histories and where they have received recent treatments.

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What paramedics really need, Langabeer says, is a statewide registry for controlled substances to quickly understand medications that patients are on. “Any information we can electronically bring to a paramedic is where we want to go with EMS.”

Session 123, “Mobile Innovations and Telehealth in Emergency Care,” is scheduled at 2:30 p.m. on February 21 in Room 206A.

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