First Net Revisits Telehealth

FirstNet Authority’s Public Safety Advisory Committee’s https://firstnet.gov/about/psac (PSAC) Telehealth Strike Team is revisiting the use of telehealth in a number of situations but especially during the COVID-19 pandemic.

The PSAC Telehealth Strike Team was originally set up to examine new applications of telehealth particularly as related to the Emergency Triage, Treat, and Transport (ET3) pilot program which the Center for Medicare and Medicaid Innovation (CMMI) runs.

With the pandemic, the PSAC Telehealth Strike Team worked to identify current uses of telehealth in the prehospital environment. The Strike Team developed a web-based survey for EMS providers.

The survey provided a response on how telehealth had been effectively used. In one situation. A 56 year old man had been diagnosed with COVID-19. He had been doing well with home care, although over the past four days, he had experienced a gradual worsening in shortness of breath with chest pain and a fever.

His wife was concerned and called 911 to request EMS support. The patient did not want an assessment by paramedics and adamantly did not want to go to the hospital. The EMS crew was concerned when they found that the patient had a very rapid heart rate, low oxygen saturations, visible difficulty breathing, and difficulty with his ability to walk.

The EMS crew then established a telehealth session using their broadband enabled tablet with the patient’s consent. The session included both an on-duty physician at the local hospital and their supervisor who was assisting them on the scene.

The physician talked to the patient and his wife and then assisted the paramedic with a more detailed assessment and evaluation. Throughout the consult, the physician relayed his concerns for the patient’s prognosis obtained from the findings from the assessment.

The patient eventually agreed to be transported to the hospital. He was found to have bilateral pulmonary emboli, resulting in an immediate aggressive treatment plan and admission. Several days later, he was discharged home without any ongoing effects from what would have likely been a fatal condition without the appropriate interventions.

This case demonstrates how telehealth can be used to save lives. With the ongoing impact of the pandemic and its variants on the nation’s healthcare  system and communications networks, EMS crews and emergency departments should integrate telehealth into daily operations