LOL! I love how every city to try something thinks they are the first ones. This is certainly nothing new. Dallas tried this over twenty-five years ago, ended up killing at least three people, getting sued in a big way, and scrapped the program. The city was judged liable for a patient's death. One nurse lost her license and a wrongful death lawsuit, and was literally run out of the state by numerous death threats. A fire captain and assistant chief were fired or demoted. All the other nurses quit, and the city quietly ditched the whole program. This is why most physicians do not practice telephone medicine. In order to evaluate someone, you need to actually see them. Anything less is taking a serious chance with their lives and your license.
Who knows. Maybe Houston is so much smarter than the rest of the world that they have actually discovered the key component to making this work. After all, in theory, it is a valid concept. But more likely, they're simply intent on repeating the same mistakes that others have suffered to finally determine that it was a waste of time, money, and lives. Hopefully they have the common sense to look at what has already been done before trying to reinvent the wheel. They should start by Googling "Lillian Boff". Here's a good article to start with:
http://www.aintnowaytogo.com/911Call.htm
"Texas: It's like a whole nother country"
Wasn't that the tourist promotion slogan?
Al these nurse on call lines are algorythms. Usually they end at: "if you really think it is an emergency, then you should go to the hospital." When the patient gets there they of course think they get some kind of expedited treatment because "the nurse told them to come in."
Something that agencies providing EMS need to get through their thick heads is that the public doesn't need a service that only handles "true medical emergencies" they need a service that thye have access to. We all know more than 90% of all "emergencies" are not. This line of "paramedics were wasted and didn't go to somebody who truly needed them" is
complete BS and either ignorance or arrogance.
Somebody will spout some crap about response time. But lets have a look at the mythical 8:59 rule. I was told that o2 debt start immediately upon an insult. 6-8 minutes of debt before permanent injury. So you get there x% of the time a minute after, the vegetable garden must really love your efforts.
I love how angencies talk about how they serve the public but want to decide how and when. Where do I get a job where I decide what work I will do and when? Get paid for sitting around waiting for something "important" to happen?
Is it a waste of money to use the "emergency system" for healthcare in the US? You bet it is, but there is not another system that is readily available. Welcome to "serving" the public. If an ED doc with more education andtraining than most EMS providers will ever have can spend time treating non emergent patients doing things like interpreting HCG tests, dolling out flu dxes, seeing the child with a "fever" I'd like to hear the skill and knowledge you possess that exempts you from such menial tasks?
As for the "nurse line" AJ touched on it. Unless you have a fund for "acceptable losses" deciding an emergency over the phone, it's only a matter of time before people die. Hell I can't always get an accurate history staring a patient in the face. (for some reason nonmedical people never share the same attention to medically significant details that I do)
I guess the benefit is you are creating employment during these tough times. Also adding a "middleman" to a 911 call (for the patient who might truly need your help) and how long do you think it will take for the callers to figure out exactly what they need to say to get the ambulance anyway?
"I'm having chest pain and difficulty breathing I need an ambulance"
when they have a different compliant on arrival, what are you going to do then, accuse them of not having chest pain and difficulty breathing? recoup the cost of a "wasted" run? Lots of luck with that.
The problem isn't abuse of EMS the problem is EMS not meeting patient needs.