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With Telemedicine, Paramedics Use iPads to Connect Patients to Doctors

Paramedics and EMTs undergo hundreds of hours of training to know how to respond to a health emergency, but sometimes, nothing can take the place of a physician’s input. Allegheny Valley Hospital is the first in the state to solve this problem by allowing its paramedic response units to connect patients to hospital physicians via iPad in an initiative called “telemedicine.”

EMS providers need to make a number of judgment calls, including how serious the patient’s condition is, whether they need to be taken to a hospital, and even which hospital specializes in the treatment they need. To make these decisions, EMS providers communicate with physicians via cell phone or ambulance radio, describing the patient’s condition and appearance. Now, the doctors can “see” for themselves.

“Our hopes are that it will result in a more aggressive treatment plan in the field, direct the patient to the most appropriate hospital based on their condition or injury, and the final result is that we have higher survival rates,” said Jeff Polana, director of pre-hospital operations for Allegheny Valley Hospital.

Polana said basic health complications, such as broken bones and common chest pains, will still be assessed by paramedics in the usual way. However, when EMS providers encounter a more subtle condition that requires specialized knowledge to recognize, a doctor is now only a FaceTime call away.

“We would call the physician in the emergency department via iPad,” explained Polana. “We have a computer in the emergency department. The doctor would then sit in the command center with headphones in place and the connection would be made so the physician actually could meet the patient and ask further questions than maybe the paramedic did in the field.”

Polana helped to spearhead the development of the new system after seeing similar technology being used in Britain. He says the new visual and audio connection between patients and physicians eliminates many of the problems paramedics and EMTs faced before.

“The paramedic’s in the field giving a report, trying to explain the whole situation,” Polana said of the old system. ”There may be an interaction of questions back and forth, where then the paramedic would have to take a break from speaking to the doctor and ask the patient some questions and then get back on the phone to speak to the physician.”

Paramedics were often limited by their ability to describe patient symptoms over the phone and had a hard time conveying just how serious conditions were, according to paramedic Gary Cockroft.

“Basically, now that the physician’s able to see the patient, they can decide for themselves how great the symptoms are, you know, if these symptoms are more impressive than what we were able to verbalize,” Cockroft said.

Cockroft has been a paramedic for 24 years and said the recent changes in technology have made his job much easier.

The new system launched in March, and has been used with 12 patients so far. While patients are charged for the cost of the ambulance visit and paramedic consultation, there is no additional fee if they agree to speak to a doctor via iPad. That may change once the telemedicine system loses its “pilot” status.

Polana said patients have had a positive response to the new technology.

“Some of the medics have told me when this happens in the field, after they’re done, the patient will say, ‘Wow, that doctor was in my living room!’ This makes them feel so much more comfortable, knowing that they’re going to get good care,” Polana said.

Currently, the pilot project is only used by the eight-member paramedic response unit at Allegheny Valley Hospital, which is gathering information to present to the Pennsylvania Department of Health to have similar programs approved across the commonwealth. The total cost for the computers, iPads, paramedic training, and legal clearance was less than $10,000, according to Polana.