Helping patients who don't need 911

July 20, 2009 4:19:35 PM PDT
The healthcare crisis is on the national agenda. But Houston, like other cities, has been dealing with it for years. The Houston EMS service and hospital emergency rooms, which are both strained, are on the frontline. A proposal may gradually help change that, one patient at a time.There are about 700 ambulance runs a day by the Houston Fire Department. In a lot of cases, they are life saving trips. But of all the calls paramedics make, the most recent report shows only a third of the patients actually needed to go to an emergency room. Nearly half of the calls were because there was no one to take them to the hospital.

Houston EMS Director Dr. David Persse explained, "In about 80 percent of them, all we do is transport, no lights, no sirens, no treatment, no splinting, no bandaging, no oxygen. It's just transportation."

It takes ambulances out of service for what are not medical emergencies. It also crowds emergency rooms for what could be handled with a clinic visit. For the past year the Houston Emergency Center has had a triage nurse linked in to dispatchers, to divert non emergency cases from ambulances and ERs. It saves about two trips a day. That's not a huge number, but there are benefits.

Karen Love with the Harris County Healthcare Alliance explained, "It is finding people who we can hopefully help with transportation and medical home connections."

That means neighborhood health clinics, and it also means getting to them by cab. So the city is poised to invest $250,000 from a health fund city contractors pay into a triage pilot project -- making a clinic appointment for a qualifying patient, paying for the first visit and the transportation to get there, if all goes according to plan.

"The only time they will call 911 again is in a true emergency because they will have somebody that they will regularly call to ask questions or to seek care," said Elena Marks with the Houston mayor's office.

For $250,000, the program could divert 1,750 people from ambulances and ERs. City council is scheduled to vote on the proposal this week.

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