Whats your take ???

Can anyone refer us to some legitimate, published studies that show where one of these public education programs has resulted in a significant reduction in 911 call load without resulting in significant mis-triage of patients? It all sounds very nice in the theoretical world. And more than a few agencies have tried it, but I have yet to hear any solid evidence supporting it. Anyone?
 
Ms.Medic said:
Here's an interesting link with some info on these type of programs.
http://firechief.com/ems/firefighting_taxi_twist/

But AJ, I will get that captians name as soon as I have time to look through our stuff and find it so that you can google it and see if all of his research helps...It may and may not.
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Just read that article, most of it is reducing transport. The service going to urgent care is probably the best alternative. It saves money for the service, the party paying, and the resources in the hospital.

The rest are not reducing responses, just transport, which according to the current billing environment is just costing the service money.

Tiered responses can be even more costly in some instances.

Most of these chief's should be fired. They are neither forward thinking nor effectively handling the challenges of EMS in the 21st century.

I don't really like to see people fail, but I have to say, many FDs thought EMS would be the savior of their budgets and value to the community. It looks like they just strapped an anchor to their boots and jumped into the deep end.

Now as they sink they have a laundry list of what they are not going to do to fix it. The bright side is, after they sink to the bottom and drown, the problems might actually get solved.
 
This is what is on offer here in New Zealand which is funded by the Government for those people with a medical issue.
Some folk do not want to dial 111 (911) as they don't think that they problem is that urgent.
The nurse can determine if it is and arrange help for them, or other action as required.

http://www.moh.govt.nz/healthline

Enjoynz
 
Ms.Medic said:
I'd like to see what everyones take on this is....
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Sounds a lot like Telehealth Ontario to me. Where I live we have a service similar to this and since it has been in place I have had Code 4 (Lights and Siren) calls to someone who were not even expecting an Ambulance. I think it is a good idea but I have heard that due to liability issues anything slightly iffy gets an Ambulance. Not sure just my opinion.

Good idea on paper but does it work in reality.
 
Veneficus said:
The problem with this many people perhaps not in your area) do not have any alternative to the ED and EMS.
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Actually we have nothing closer than 60 miles away, nearest hospital is 90 miles. Still does not mean I should transport a person that does not need an ambulance. There are government funds that will pay a private person mileage to take you to the doctor. We give patients the info to that. We give them numbers to big city's services. We help them find what they need. But if they do not need an ambulance we do not transport.
 
medic417 said:
Actually we have nothing closer than 60 miles away, nearest hospital is 90 miles. Still does not mean I should transport a person that does not need an ambulance. There are government funds that will pay a private person mileage to take you to the doctor. We give patients the info to that. We give them numbers to big city's services. We help them find what they need. But if they do not need an ambulance we do not transport.
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I really don't see a problem denying people when services do exist, but in many places I have worked there is nobody to call but the ambulance.

even spent some time at a service that was permitted to refuse treatment or transport, but it really wasn't practical in that area. By the time you filled out the paperwork, you could have made 4 more runs.
 
Veneficus said:
even spent some time at a service that was permitted to refuse treatment or transport, but it really wasn't practical in that area. By the time you filled out the paperwork, you could have made 4 more runs.
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So just transporting is better than educating? I disagree. It is better use of time to educate and later reap the benefits of fewer non emergent calls.
 
medic417 said:
So just transporting is better than educating? I disagree. It is better use of time to educate and later reap the benefits of fewer non emergent calls.
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I agree people should be educated. But I do not agree that in an area which doesn't have alternative sources of help like yours, leaving somebody on the doorstep without other options is not right either.

In the area I referred to in my personal experience, the only other possible way to get to the charity hospital was a cab ride. There were no vouchers or programs to pay. So even after you educated them, you might have left a person needing care but not an ALS ambulance standing in the driveway.

The protocols for refusal were also so poorly written and the process so cumbersome, it had little benefit. Especially after some caught on to the magic words "chest pain." rather than being revised the protocol was scrapped, which was not the right decision either. But the medical direction (a panel of doctors who had to approve protocol that one signed off on) was not amiable to revision.

With the environment you describe yours as, refusal of transport is a viable and worthy option.
 
medic417 said:
Here is a reference that shows what medical transportation is available per state.

http://www.kff.org/medicaid/benefits/service.jsp?yr=3&cat=3&nt=on&sv=21&so=0&tg=0
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But it doesn't give links or phone numbers to those transportations(unless I'm missing it), just that coverage under medicaid is available in those states for ambulance and non emergency transport.

They're a benefit covered by medicaid, that's great, but it doesn't assist people in arranging for said transport.

I'm wondering if you even looked at the site you posted a link to.
 
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Sasha said:
But it doesn't give links or phone numbers to those transportations(unless I'm missing it), just that coverage under Medicaid is available in those states for ambulance and non emergency transport.

They're a benefit covered by Medicaid, that's great, but it doesn't assist people in arranging for said transport.

I'm wondering if you even looked at the site you posted a link to.
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Ummm yes it was a reference to Medicaid benefit being available for non emergent medical transportation. Contact your state Medicaid office for details of how it works in your state. In Texas a person can actually get paid to use their own car to go to the doctor. It more than covers the gas. It can pay hotels and meals if travel is very far. There are some Medicaid programs that pay taxis or buses to transport. I have even seen them pay for airfare when the distance was far for specialized treatment.

Sorry I did not spell out that if your state showed a transportation benefit to contact them.
 
medic417 said:
Ummm yes it was a reference to Medicaid benefit being available for non emergent medical transportation.
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That's not what you said, this is:

Here is a reference that shows what medical transportation is available per state.
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That lead's someone to believe that you were providing a list of what medical transport was available per state. Not that you were simply providing a webpage that says "Yes! Medicaid covers it". So, what if you don't have medicaid? Not everyone fits into that formula for medicaid but still can't afford insurance. The formula for medicaid counts on you spending your money the way the government feels you should and does not take into account the very different family dynamics of each household.

Sorry I did not spell out that if your state showed a transportation benefit to contact them.
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I was not even aware that medicaid was part of this thread until you posted that list.

Edit. I just went back and read the thread. Your link was the first reference to Medicaid.
 
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Sasha said:
That's not what you said, this is:



That lead's someone to believe that you were providing a list of what medical transport was available per state. Not that you were simply providing a webpage that says "Yes! Medicaid covers it". So, what if you don't have medicaid? Not everyone fits into that formula for medicaid but still can't afford insurance. The formula for medicaid counts on you spending your money the way the government feels you should and does not take into account the very different family dynamics of each household.



I was not even aware that medicaid was part of this thread until you posted that list.

Edit. I just went back and read the thread. Your link was the first reference to Medicaid.
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Sorry we were discussing services available I just listed one that appears to be available in all states. You can also look at Medicare site and even many private insurances will help. There are many sources that are out there including church groups. OOPs no one mentioned church so now are you going to condemn me for presenting more options that we could educate ourselves to first then educate our patients that do not need ambulance to next.
 
medic417 said:
Sorry we were discussing services available I just listed one that appears to be available in all states.
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You didn't list a service resource.... You listed evidence that medicaid covers a service.
 
Sasha said:
You didn't list a service resource.... You listed evidence that medicaid covers a service.
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Anyone that took a second would be able to do a little research and find their states medicaid provider. Not a difficult task. You benefit more if you do a little of the work yourself rather than having everything spoon fed to you.
 
medic417 said:
Anyone that took a second would be able to do a little research and find their states medicaid provider. Not a difficult task. You benefit more if you do a little of the work yourself rather than having everything spoon fed to you.
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Actually.. I did a little more work than you. I actually read the site you posted. You're backtracking. Medicaid was not even a subject in this thread. How is medicaid a resource to get to the hospital? It's not. It's a resource to help pay for it. Instead of "Hey, you're right, I didn't read this all the way" you're trying to be insulting.
 
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Sasha said:
Actually.. I did a little more work than you. I actually read the site you posted. You're backtracking. Medicaid was not even a subject in this thread. How is medicaid a resource to get to the hospital? Instead of "Hey, you're right, I didn't read this all the way" you're trying to be insulting.
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I did read read the site.

Medicaid has a medical transportation program. It can pay them to use there car. Or if they have no car it can pay their friend to drive them. It is directly related to the discussion. Discussion had evolved and I presented a source if you would look into it you might learn something.
 
medic417 said:
I did read read the site.

Medicaid has a medical transportation program. It can pay them to use there car. Or if they have no car it can pay their friend to drive them. It is directly related to the discussion. Discussion had evolved and I presented a source if you would look into it you might learn something.
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Your website does not even provide information about that. Your site provides information regarding coverage for non emergency and ambulance transport. Then it defines them once you click on them and tells you if there is a co-pay or not. Nowhere does it list anything about the type of service you spoke of.
 
Sasha said:
Your website does not even provide information about that. Your site provides information regarding coverage for non emergency and ambulance transport. Then it defines them once you click on them and tells you if there is a co-pay or not. Nowhere does it list anything about the type of service you spoke of.
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You then should be able to go so there is some benefit in my state, how would I learn about it? I know I'll look up my state medicaid office and see what all my state includes. Not complicated. Should not require someone to draw a map.
 
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