The Nebraska Department of Health and Human Services (DHHS) has recently completed the implementation of state-wide emergency telemedicine services for Emergency Medical Services (EMS) in partnership with Avel eCare. This initiative, finalized in June 2024, represents a significant advancement in pre-hospital care for rural communities across Nebraska.
This article examines the implementation and impact of emergency telemedicine services in Nebraska’s rural EMS system, exploring its benefits, challenges, and potential for future healthcare delivery.
Scope and Implementation of Emergency Telemedicine Services
The program has equipped over 65 ambulances across at least 26 rural communities with advanced emergency telemedicine services technology. These systems include cabin-mounted telehealth tablets designed to maintain strong connectivity in remote areas. The initiative covers a diverse range of EMS providers, including Basic Life Support, Advanced Life Support, 911, and transfer services.
The program reports substantial utilization of emergency telemedicine services since its initial rollout in December 2023. Emergency telemedicine services are being actively used, with the most frequent calls for assistance involving:
- Trauma cases
- Altered mental status
- Cardiac issues and chest pain
These categories highlight the system’s utility in complex medical situations where additional expertise can significantly impact patient outcomes.
Technology Behind Emergency Telemedicine Services
About 46 million people live in rural America. These individuals have higher rates of severe illness and death from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than the urban population. In addition, people living in rural areas may be limited from accessing the quality medical care services they need.
The benefit of Avel eCare emergency telemedicine services is that it provides rural residents access to:
- Real-time consultations with emergency physicians, paramedics, and nurses
- 24/7 interpretation services
- Remote ECG readings
- Diagnostic test reviews
- Pre-hospital documentation support
This array of EMS telemedicine services effectively creates a virtual emergency room environment within the ambulance, enhancing the capabilities of on-site EMS personnel.
Benefits and Future Prospects of EMS and Telemedicine
The implementation of emergency telemedicine services in rural EMS addresses several critical challenges:
- Provides crucial support during complex medical situations
- Assists during long-distance patient transports
- Offers additional expertise when only one provider is available with a critical patient
- Enhances decision-making through peer-to-peer consultations
- Improves documentation, potentially aiding in continuity of care and medico-legal aspects
The initiative is supported by a $1.3 million grant from the Centers for Disease Control. This funding aims to bolster Emergency Health Systems in rural areas by:
- Supporting recruitment and retention of EMS personnel
- Reducing health disparities in underserved populations
- Improving access to high-quality emergency care in remote areas
Research Implications and Data Integrity
While this large-scale implementation of EMS telemedicine provides a unique opportunity for future research, it also highlights the importance of data integrity in healthcare reporting. Potential areas of study include:
- Accurate measurement and reporting of utilization rates and growth
- Impact on patient outcomes in rural vs. urban settings
- Cost-effectiveness of telemedicine in reducing unnecessary hospital transfers
- Effects on EMS personnel job satisfaction and retention rates
- Influence on treatment times and adherence to best practice guidelines
Understanding How Telemedicine is Used In EMS
Nebraska’s emergency telemedicine services program is advancing in rural emergency care by leveraging technology to bridge the gap between remote locations and specialist expertise. As the program continues to evolve, it may serve as a model for other states facing similar challenges in rural healthcare delivery. However, it also underscores the need for rigorous data collection and reporting to accurately assess the impact and effectiveness of such innovative healthcare solutions.
