Category: News

General Dynamics Land Systems – Canada has selected LifeBot as a source of supply for its telemedicine, medical equipment and medical engineering support needs in designing and building a new Light Armoured Vehicle Ambulance variant.

LifeBot shall provide General Dynamics Land Systems – Canada (GDLS-Canada) mobile telemedicine and a lightweight and rugged ALS Defibrillator. The modular, scalable design of LifeBot’s telemedicine and defibrillator solutions along with the ability to provide an integrated Electronic Patient Call Report (e-PCR) or Medical Record (EHR) with live physiological data are key differentiators of LifeBot’s medical solutions.

LifeBot is the only mobile telemedicine system to include resuscitation capabilities. It is also the only system that stores medical records for both online and offline use. Now known as LifeBot Mobility™, the system dynamically updates these patient records across whole groups of LifeBot field systems, or ambulances, using a Central Data Repository records server.

Unlike other telemedicine systems, patient records include critical physiological data or vital signs information acquired and integrated automatically. These are the critical features needed for advanced Mobile Integrated Healthcare and Community Paramedicine programs.

LifeBot will be a source of supply for all the installed medical equipment for these vehicles including the LifeBot 5 Mobile Telemedicine System for the collection and communication of vital medical information. Other military medical systems are dependent on the medic to be the integration point for monitoring data, medical record keeping and communications. With LifeBot, the medic or nurse can focus more on patients and providing quality of care.

LifeBot systems are modular and readily upgradable to new technologies as they become available. This assures non-obsolesce and use of improved modes of care in the future. This can also be instrumental in significantly reducing costs long term.

We are very proud to be working with General Dynamics Land Systems – Canada. This contract is part of the realization of a dream to make the most advanced systems for battlefield and commercial use in mobile medical care. We have taken these military developed technologies and fused them into an affordable single small, lightweight, ruggedized and portable system. We have added resuscitation capabilities making this the most advanced mobile care system in the world. Roger Heath, CEO

LifeBot has the exclusive world-wide license on DREAMS (Disaster Relief and Emergency Medical Services) telemedicine technologies developed with U.S. Army Medical Research and Materiel Command and the Telemedicine and Technology Research Center (TATRC) under a $14 million in grant.

LifeBot CEO, Roger Heath, stated, “We are very proud to be working with General Dynamics Land Systems – Canada. This contract is part of the realization of a dream to make the most advanced systems for battlefield and commercial use in mobile medical care. We have taken these military developed technologies and fused them into an affordable single small, lightweight, ruggedized and portable system. We have added resuscitation capabilities making this the most advanced mobile care system in the world.”

Renowned market research firm, Frost & Sullivan, after an extensive independent research study, recently awarded LifeBot it’s 2014 New Product Innovation Leadership Award for Portable Telemedicine Solutions. This study is now available to everyone as a free download on the LifeBot web site. ↓ view download report now

About General Dynamics Land Systems – Canada: General Dynamics Land Systems – Canada is a part of the Combat Systems business group of General Dynamics and is a leader in light armoured vehicle platforms and sub-system integration.

For information about General Dynamics Land Systems–Canada, please visit: ↓ www.gdlscanada.com

Independent research of the leading telemedicine solutions by Frost & Sullivan has resulted in LifeBot receiving their 2014 Award for New Product Innovation Leadership for Portable Telemedicine.

To download and view the full report free click: ↓ download report

↓ download newsletter pdf file version

The Process of Research: Frost & Sullivan sent out teams of global analysts and industry experts searching for leading mobile telemedicine companies achieving dual excellence in two critical areas, Implementation Excellence and Product Excellence.

Their search concentrated on companies that not only had a vision, but that were also able to turn that vision into reality. The process included their global network of consultants, analysts, and industry peers. After an independent Board of Directors vetted their findings, one company stood out from the rest, LifeBot.

Telemedicine is the Future: It is now estimated by Deloitte’s Center for Health Solutions that telemedicine will save $500B annually in productivity.(1) Having the right patient data or information in a timely manner is critical. Telemedicine has shown it may reduce medical errors as much as 75% in treatment of trauma, as just one example.(2)

Selection of an able vendor or supplier for this demanding technology will determine if it was a good investment long term. Most will fall by the wayside, limited by the scope and breadth of their expertise; by the ways they address the real problems presented by such rapidly developing technologies in so many medical specialities. Most telemedicine solutions are already limited by performing very costly video conferencing only.(3)

Telemedicine Must Be Mobile: A new breed of mobile community paramedic is beginning to show up on the scene.(4,5) Indications are that 85% of healthcare will be done in the home or in remote clinical settings in next five or six years.(6) A paradigm shift is coming for digital health.(7)

The Mobile Micro-Hospital or Emergency Room: For these purposes the LifeBot 5 is being deployed in numerous applications. Such telemedicine solutions must be readily portable and perform a multitude of procedures in multidisciplinary fashion. They should be able to manage medical records exchange, treat the most innocuous of symptoms, but also be able to respond to serious life threatening issues, like resuscitation, yet still be rugged enough to manage care on the battlefield, or during major events or disasters.

We very much appreciate this award. We have been working very hard to build solutions that will truly be able to provide continuity of care clinically, and in mobile use, but all the way into the home. It is a dream that began here well over ten years ago, and it is still unfolding each day. Roger Heath, CEO

It is for these reasons, and more, that Frost & Sullivan has awarded LifeBot the New Product Innovation Leadership Award. LifeBot CEO, Roger Heath, responded by saying, “We very much appreciate this award. We have been working very hard to build solutions that will truly be able to provide continuity of care clinically, and in mobile use, but all the way into the home. It is a dream that began here well over ten years ago, and it is still unfolding each day.”

Frost & Sullivan presents this award to the company that has demonstrated uniqueness in developing and leveraging new technologies, which impacts both the functionality and the customer value of the new products and applications. The award lauds the high R&D spend towards innovation, its relevance to the industry and the positive impact on brand perception.

Frost & Sullivan Best Practices awards recognize companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service and strategic product development. Industry analysts compare market participants and measure performance through in-depth interviews, analysis and extensive secondary research to identify best practices in the industry.

About Frost & Sullivan: Frost & Sullivan, the Growth Partnership Company, enables clients to accelerate growth and achieve best in class positions in growth, innovation and leadership. The company’s Growth Partnership Service provides the CEO and the CEO’s Growth Team with disciplined research and best practice models to drive the generation, evaluation and implementation of powerful growth strategies. Frost & Sullivan leverages almost 50 years of experience in partnering with Global 1000 companies, emerging businesses and the investment community from 31 offices on six continents. To join our Growth Partnership, please visit website: www.frost.com

References:

(1) mHealth tools projected to save $500 billion in productivity by 2021, EHR Intelligence Jan. 2013.

(2) Telemedicine May Be The Answer For Rural Trauma Surgeons, Surgical Products Oct. 2009.

(3) Video Conferencing is NOT Telemedicine, Roger Lee Heath August 2011.

(4) How EMS will benefit from smartphones and connected vehicles Dia Gainor Interview ems1.com Sept. 2014.

(5) New designs for future ambulances: the Emergency Care Practitioner (ECP) BBC News, April 2013.

(6) mHealth forecast wows audience Healthcare IT News Dec. 2013.

(7) Paradigm shift coming for digital health Healthcare IT News Nov. 2014.

University of Maryland Upper Chesapeake Health and Lorien Health Systems
Awarded Telehealth Grant Hospital and skilled nursing facility work together to improve patient quality of life.

University of Maryland Upper Chesapeake Health (UM UCH) has received a $30,000 grant from the Maryland Health Care Commission to establish a pilot project demonstrating that telehealth technology can be used to improve care transitions as patients move between hospital and nursing facilities.

UM UCH is partnering with Lorien Health System’s Bel Air senior community and LifeBot Telemedicine to show how patient care can be improved and cost savings achieved by reducing unnecessary visits to hospital emergency rooms and unnecessary hospital admissions and re-admissions.

Watch the video of live use of the LifeBot 5 and Clinical Workstation at Lorien Healthcare and University of Maryland Upper Chesapeake.

During the pilot project, the physicians at the University of Maryland Upper Chesapeake Medical Center (UM UCMC) Emergency Department will conduct remote “telehealth” assessments of Lorien Bel Air patients. These patients will remain at Lorien in its new examination room which is fitted with video cameras, microphones and other specialized equipment. Working in consultation with the patient’s attending physician, UM UCMC physicians will analyze a patient’s status and any change of condition and will determine a course of treatment including whether it is medically necessary to transfer the patient to UCMC’s emergency room.

Lyle E. Sheldon, CEO of UM UCH said, “We are excited about the possibilities of using this technology to get a patient assessed earlier and maybe to avoid an unnecessary trip to our emergency department. Pilots like this also afford the opportunity to build closer relationships with our community partners in health care such as Lorien Health.”

Louis G. Grimmel, Sr., CEO of Maryland – based Lorien agreed. “Our Lorien Bel Air community has been a preferred location for quality assisted living and nursing care for over 10 years. We’re very excited to participate in this grant project as we are dedicated to continual innovation and investment in new technologies to meet the needs of our customers in the ever evolving health care system.”

Lorien Bel Air is connected to UM UCMC with the LifeBot Telemedicine system. According to Kerry Fletcher, COO at LifeBot, “Advanced Telemedicine is the solution to improved patient care while reducing costs, and LifeBot is proud to participate in the grant initiative. The LifeBot 5 is a ‘mobile micro-hospital’ which provides the consulting physician with not only multiple camera views for complete visual assessment but also the same real-time physiological data as if the patient was located in their ICU. Having access to the patient’s data, in a format that makes true Health Information Exchange (HIE) possible, allows the doctor to make better decisions without the disruption or cost associated with non-emergency transport.”

Lorien Bel Air is connected to UM UCMC with the LifeBot Telemedicine system. …The goal of this partnership will be to improve the patient’s quality of life by reducing avoidable acute care transfers, admissions and re-admissions.

The goal of this partnership will be to improve the patient’s quality of life by reducing avoidable acute care transfers, admissions and re-admissions. The intent is to create a sustainable care model that can be replicated in additional locations.

The pilot will run from December 2014 until July 2015 with a final report due to the state at that time. Maryland Emergency Medicine Network will be providing the consultative services on behalf of the UM UCMC Emergency Room. For more information about the grant, call 443-643-4219 at UM UCH.
About University of Maryland Upper Chesapeake Health

University of Maryland Upper Chesapeake Health (UM UCH) is a community based, not-for-profit system located in Harford County, Maryland, and dedicated to maintaining and improving the health of the people in its communities through an integrated health delivery system that provides the highest quality of care to all. UM UCH owns and operates UM Upper Chesapeake Medical Center in Bel Air, UM Harford Memorial Hospital in Havre de Grace, Upper Chesapeake Health Foundation and the Senator Bob Hooper House, an assisted living facility specializing in hospice care located in Forest Hill. UM Upper Chesapeake Health is also an affiliate of the University of Maryland Medical System. One of the largest private employers in Harford County, Upper Chesapeake employs almost 3,000 team members. Visit www.umuch.org to learn more.
About Lorien Health Systems

Lorien Health Systems is family owned and operated company that offers a continuum of services for seniors, including health and wellness programs, community – based services, inpatient skilled nursing and rehabilitation services, long term care services, and assisted living community housing. Lorien has over 2,000 employees and operates five Assisted Living and nine Skilled Nursing facilities in Central Maryland including Harford, Howard, Carroll and Baltimore counties. The company also includes Advantage Fitness and Rehabilitation, which provides inpatient and outpatient services, and a licensed Residential Service Agency which provides community-based services under its new “Lorien at Home” program.

LifeBot is Preparing to Release Fully Integrated Ultrasound for its Portable LifeBot 5 Telemedicine Systems.

After considerable preparation LifeBot is about to release the first fully portable ultrasound equipped LifeBot 5. This will be the first and only portable ultrasound system designed to send live ultrasound with built in wireless connectivity management and simultaneous full patient physiological parameters. 

Above image shows the popular LifeBot 5 system with integrated ultrasound capabilities. Unique to the design is built in connectivity, multiple cameras, sending of a host of other critical patient physiologic data.

Below image shows four active cameras, including ultrasound all being received on the LifeBot Clinical Workstation system.

The ultrasound system will be complimented with nine probes for many different procedures. It is expected to be popular for fast assessment of patients in outpatient, senior care, or emergency situations. Ultrasound is for a wide range of applications, from guidance, to monitoring therapeutic treatments, ophthalmology, vascular imaging, urodynamics, telemedicine, and general purpose imaging.

But, what is unique about the integration is that live ultrasound images may be sent from anywhere and at any time to remote physicians, along with video, audio, and a long list of critical physiologic patient information.

The images shown here are for the benefit of those who already have LifeBot 5 systems ordered with ultrasound or that may wish to add this capability to their portable telemedicine systems.

Since the LifeBot 5 system is a fully modular construction, it may be easily updated or upgraded while, at the same time, controlling such costs.

LifeBot, LLC announced today that it is delivering on orders of its new LifeBot 5 in just weeks. The LifeBot 5 is the world’s smallest, lightest, most advanced portable mobile telemedicine system.

Phoenix, AZ, USA October 22, 2012 : LifeBot, LLC announced that it is beginning deliveries of its new advanced telemedicine system called the LifeBot 5. According to the company, two state telemedicine programs have ordered or contracted for delivery of the advanced DREAMS™ telemedicine systems.

LifeBot acquired the exclusive world-wide license to DREAMS™ (Disaster Relief and Emergency Medical Services) and has reduced the system to a miniaturized lightweight portable unit that may be used anywhere at anytime. The original system was developed under DOD grants of $14 million from the Telemedicine and Technology Research Center (TATRC) and U.S. Army Medical Research and Materiel Command (USAMRMC).

The new LifeBot 5 promises to revolutionize the way remote care is delivered and reduce both the risks and costs of deploying telemedicine systems in both hospital-to-hospital and hospital-to-ambulance communications.

Faster Deployment: Reduced Costs Saving More Lives

The base collaboration LifeBot 5 is very affordable, beginning under $20,000. The system may be less than half of the cost of most existing telemedicine systems that have many less critical features. Being portable, the LifeBot 5 may be installed instantly and at less costs putting life-saving telemedicine systems on the fast-track to full scaled deployment.

The Intelligent Communications Manager (ICM)

The system is the only portable telemedicine system with critical wireless connectivity management on-board. Developed exclusively as a part of the DREAMS™ Project, the ICM transparently manages 4G, 3G, LTE, WiMax, Cellular, Wi-Fi, Satellite, and Data Radio connections automatically aggregating what works. This proven system gives new efficacy to mobile telemedicine and pre-hospital ambulance operations even in very low-bandwidth situations.

The Interceptor™ : Full Patient Monitoring Built-In

The LifeBot Interceptor™ is an on-board medical electronics module that allows for direct patient connection and full physiological monitoring. The system offers the largest display in the business, 10.2 inches diagonally. The need for a separate monitor and its associated extra patient connections are eliminated.

The LifeBot Interceptor™ compliments live video and voice transmissions with live patient monitoring, and remote data transmissions of live clinical waveforms for single lead ECG, 12-Lead ECG, HR, NIBP, dual invasive BP, SpO2 with plethysmogram, etCO2 with capnogram, tpCO2, and dual temperatures integrating popular MasimoSET® technologies.

Finally It’s Your Data : 5-Second 12-Lead STEMI Transmissions

The LifeBot Interceptor™ intercepts critical data directly from the patient. This information is sent automatically “live” in just seconds and it is securely shared only with the parties involved. There is no need for expensive separate third-party servers or additional related expenses to hospitals.

12-Lead ECG reports are sent automatically. In addition, 12-Lead reports, in Adobe PDF formats, may be instantly emailed directly to interventional cardiologist’s computers or cellphones. A cath lab “STEMI Alert” may be initiated from both the ambulance and hospital locations in just seconds.

Interact with Existing ePCR and Electronic Medical Record Systems

While the LifeBot 5 has the first live ePCR (Electronic Patient Call Report) system built-in, web browser interfaces are integrated to provide ready access to existing web-based ePCR systems and Electronic Health Record (EHR) systems.

Complete call reports, including 12-lead ECG reports, are generated in Adobe PDF formats which may be easily attached directly to patient records. The platform is ideal for achieving Health Information Exchange (HIE) objectives for use by Accountable Care Organizations (ACO) vieing for timely reimbursement.

Since the LifeBot 5 uses a standard SQL based on-board database server, patient information, including physiologic data, may be readily ported automatically into any medical record system.

Where is the Defibrillator?

LifeBot has patented new defibrillation technologies that will be available in the future. The LifeBot 5, however, has been designed to house the Philips FR3 miniature AED (Automatic External Defibrillator). Since the LifeBot 5 is a complete patient monitoring system, there is little need for a separate monitor defibrillator system, except for synchronized countershock and pacing procedures. Any existing defibrillator may be carried along-side the LifeBot 5 as desired.

Complete FDA Compliance

LifeBot, LLC is registered with the Food and Drug Administration (FDA). All medical device systems used by LifeBot are 510(k) premarket approved and compliant. The LifeBot 5 is one of the first systems to undergo registration under the new Class I Medical Device Data Systems (MDDS) classification.

LifeBot 5 : The Future

Unlike existing instruments, the LifeBot 5 is modular in construction so it may be readily adapted to new technologies or be easily upgraded as critical needs arise. LifeBot is taking specific steps to make the system even smaller and lighter. According to LifeBot CEO, Roger Lee Heath, “These are just the first steps towards a portable system design that will rapidly evolve. The LifeBot 5 system is already setting new standards for advancing remote care in the industry.”

An eyewitness viewing of the LifeBot DREAMS System working and an interview with those who used it for seven years on Liberty County EMS.

By Dan White on ems1.com:

In years to come, telemedicine systems like DREAMS™ will protect first responders by documenting what they did and under exactly what kind of circumstances.

A combination of hardware and software, Disaster Relief and Emergency Medical Services (DREAMS) enables advanced communications between EMS and the ER in real time. DREAMS™ was in use for several years on five ambulances in Liberty County, Texas.

DREAMS™ was originally developed as a military research project using $14 million in funding through U. S. Army Materiel Command and the Telemedicine and Technology Research Center (TATRC), in conjunction with Texas A&M University and the University of Texas Science Health Center.

The system was in use for several years on five ambulances in Liberty County, Texas. Last month I was invited to take a tour of one of these ambulances in Houston, Texas. It is arguable the most sophisticated example of a working telemedicine system in EMS. After I got a close look at DREAMS, I called up and talked to two Paramedics who actually used it.

It is arguable the most sophisticated example of a working telemedicine system in EMS. Dan White

Mike Koen, EMT-B and Executive Director at Liberty County EMS, was part of a project in conjunction with Texas A&M University and Memorial Herman. At the start of the project, the idea was to “prove that mobile telecommunications in a moving ambulance was feasible.”

DREAMS™ was used for six years in Liberty County Texas

“The biggest benefit is improved survivability,” Koen added. “First by providing better support and then later by driving the development of better training to match the new advanced skill demands. EMS is rapidly evolving and telemedicine in EMS is the next logical step.”

He reported about how they used the DREAMS™ ambulance during Hurricane Katrina, and also told me the story of how two of them were pulled into the bay to replace a closed ER during Rita.

It was during Rita when a PA on the DREAMS™ ambulance linked up with famed Trauma Surgeon James Henry “Red” Duke, Jr. at Herman Memorial for a live telemedicine consultation during a difficult hand repair.

DREAMS offers direct live transmission of voice and video, along with prioritized patient physiologic data, including 12-lead ECG, blood gases, ultrasound, e-PCR, EHR, blood pressure, and more.

EMS is rapidly evolving and telemedicine in EMS is the next logical step. We proved that because it works, and it works very well. Mike Koen

The installed hardware includes a touch screen panel and portable user interface, two roof mounted cameras, headset communications, two bar code readers for scanning supplies used, and even a card scanner. Swipe a patient’s driver’s license or credit card and their name, age, and maybe address shows up instantly on your patient record.

DREAMS stores all this data in the ambulance.

DREAMS stores all this data in the ambulance. If it loses communications due to physical location or bandwidth limitations, it will save all data until communications are re-established. Then it sends all the saved data and updates your destination on current status, sending the most relevant data first (like the ECG on a chest pain patient).

All of this data instantly populates the e-PCR, and you can stop constructing narrative from memory to complete the chart. Since many large regions use established e-PCR systems, DREAMS can also integrate and populate other e-PCR systems.

It offers remarkable flexibility. If the ER doctor wants an updated BP, he doesn’t have to ask you to take it. They can just push a button on their screen and initiate another BP reading in your truck, because the multi-parameter monitor talks to DREAMS. If he wants to increase the tidal volume on your ventilator, once again he can do it remotely without bothering you when you have your hands full. When he gives a med order he can also instant message you the exact dosage in text form to confirm the order and reduce the potential for communications errors.

On the ER’s HP touch screen, doctors can even use a stylus to circle where they want your attention. They can pan, tilt, and zoom the cameras remotely if they want to take a closer look at something. The whole idea is to improve and streamline communications through interconnectivity, and the test DREAMS system in Liberty County only had one real limitation: it only worked with one destination hospital and was intended primarily for trauma.

In this case, only Memorial Herman was connected. The hospital had two big screens, one showing live video and one showing all the physiological data. The layout of the ambulance components was clearly designed with the input of working street professionals.

My tour of the DREAMS™ Ambulance:

During my tour of the Liberty County DREAMS ambulance I was amazed how cleverly everything was placed. The cameras covered the action from different angles, yet both were well out of potential head strike zones. The printer was tucked up front out of the way, and the two bar code scanners were exactly where your hands would be naturally when pulling down supplies. The card scanner was right at the head end attendant seat.

Liberty County EMS Paramedic Supervisor Johnny Spurlock, EMT-P, also worked on the DREAMS ambulances, and I asked him what he thought the major benefits of the system were.

“DREAMS™ was designed to give us access to a Trauma Surgeon in the field. It was great knowing you could count on them to watch your back,” he said.

I asked him if he also saw potential for this technology to help select the best destination for cardiac patients and he said it most definitely would. I asked him if he wished he still had the system operational again with all the area hospitals able to receive data from it. Not a half-second elapsed before he answered, “Yes I do.”

In years to come, telemedicine systems like DREAMS™ will protect first responders by documenting what they did and under exactly what kind of circumstances. They will streamline and improve communications while re-distributing valuable time. They will give our Medical Directors real-time tools to better support their EMS professionals. Telemedicine also has the potential to improve the utilization of diminishing healthcare resources. It will help patients get the care they need when they need it.

For all of these reasons and more, these kinds of systems will become commonplace in EMS; it’s just a matter of time before they do.

DREAMS™ and Liberty County EMS have led the way by proving that telemedicine works.

 As many agree, Community Paramedicine with EMS Telemedicine is the Future of EMS Services. For more details download the Community Paramedicine Technology Guide from LifeBot. view download guide..Toronto’s Paramedicine Program shows just how successful such programs may be.

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Community paramedics helping those on the fringes

Report from CTV’s Avis Favaro and Elizabeth St. Philip

It is unsustainable to wait for the phone to ring and to respond to those life-threatening emergencies We believe strongly that paramedics have more to offer by being pro-active. Michael Nolan, President of the Emergency Medical Services Chiefs of Canada

Paramedics usually go to the aid of people in distress, but their role is expanding in some areas of the country, with emergency medical staff now becoming front-line professionals who make house calls.

They are called community paramedics, and their mission is to help patients in the community solve some of their medical and care problems before they become full-blown emergencies.Paramedics are often the first and only point of contact to the health care system for those who are housebound, or suffering psychological problems that prevent them from getting the care they need.

Emergency workers are able to identify these patients and “red-flag” as needing home care services such as nursing, the help of a social worker, or access to medical devices.

CTV News rode along with a team of Toronto-based community paramedics recently. On one day, we visited a 69-year-old man who had called 911 in trouble twice before.

Paramedics who came to the man’s aid during one of his emergency calls noticed his living conditions were poor and that he appeared to need help. So they alerted the Toronto’s EMS program, CREMS (Community Referrals by EMS).

Now, community paramedics John Klich and Debbie Wicks are paying the man a visit, with his consent. The man tells them that things are under control, but Klich and Wicks suspect the man’s diabetes is poorly controlled, leading to the emergencies and 911 calls.

An inspection of his feet shows they are in danger of infection, a common complication of uncontrolled diabetes. His legs are swollen and discoloured below the knee and he has already had two toes amputated from his left foot. With his permission, they check the man’s fridge and find there isn’t much food.

They ask the man if he checks his blood sugar every day and the man responds that he doesn’t,. The man explains that he isn’t convinced he really has diabetes.

“We really want to get him some help,” Klich tells CTV News, outside the man’s apartment, “because if he stops walking and his feet become bad, it becomes a whole new issue.

“He is one of these fellows that we caught him at the right opportunity: he is still open enough to get some help.”

John and Debbie suggest to the man that they could have a public health nurse drop in to check his feet. They also want to send someone in to educate him about his diabetes. After a few minutes of talking and negotiating, the man agrees.

Later, CTV tags along as Toronto EMS visits a large, elderly woman, who is housebound because of her walking difficulties and who has to call 911 each time she falls and can’t get up.

The team explains to the woman that there are home care services available to her that would have somebody coming in a regular basis to check on her and to offer help. They ask the woman if it’s okay with her if they start a request for a referral to make that happen. She reluctantly agrees.

Later, they will make a referral to the woman’s local Community Care Access Centre, who will follow up within 36 hours. They will then aim to send a CCAC coordinator within a week to the woman’s home to explain the services she can access.

Michael Nolan, the president of the Emergency Medical Services Chiefs of Canada, says the aim of community paramedics is to help those people who have fallen through the cracks, those people who aren’t getting help from anyone else in the community and who are relying heavily on emergency services.

“It is unsustainable to wait for the phone to ring and to respond to those life-threatening emergencies,” he tells CTV News. “We believe strongly that paramedics have more to offer by being pro-active.”

The Community Paramedics Program in Toronto has already been a success, CREMS

The community paramedics program in Toronto has already been a success, CREMS organizers say. The program has helped cut repeat 911 calls by up to 80 per cent, helping patients who usually relied on emergency medical services to manage their chronic and unaddressed care issues and finally get the regular care they need.

by Laura Landro at the Wall Street Journal

A new push is under way to improve the care people get after they call 911, when minutes can make the difference between life and death. The inside of the ambulance is changing as it is being stocked with new techniques and devices to improve trauma victims’ survival. Laura Landro has details on Lunch Break.

One Problem: Medical advances that save lives in hospitals and on the battlefields are often slow to become available to civilian emergency responders.

There is plenty of room for improvement: Survival rates among sudden-cardiac-arrest patients, for example, vary widely among different regions in the country. One problem: Medical advances that save lives in hospitals and on the battlefields are often slow to become available to civilian emergency responders.

Emergency medical systems and ambulance companies are driving the efforts to change. A growing number of communities are training their 911 call centers to instruct bystanders by telephone in the best way to administer cardiopulmonary resuscitation, or CPR, which has been shown to increase a patient’s chance of surviving. Some emergency responders are equipping ambulances with new technologies like digital transmission systems to beam electrocardiograms to hospitals and quick-clotting bandages, developed for troops fighting in Iraq, to stop bleeding faster. Paramedics—the most skilled providers of pre-hospital emergency care—also are being trained to chill cardiac-arrest patients after resuscitating them, as is often done in hospitals; the procedure has been shown to increase patients’ chances of surviving without brain damage.

Cardiac arrest kills close to 300,000 people a year in the U.S., and trauma is the No. 1 killer of people under age 44. Of those who die, more than half do so in the first two hours, before they ever arrive at a hospital.

“The goal is to train the paramedics to be as good as physicians when treating patients in the field,” says Andreas Grabinsky, head of emergency and trauma anesthesia at the University of Washington-Harborview Medical Center in Seattle, where the city and county EMS providers offer free training programs to other emergency systems.

It is difficult to introduce innovations. Emergency medical systems are generally overseen by a state or regional agency and vary by community. Ambulances may be operated by fire departments, hospitals, volunteer groups or private companies. When a 911 call comes in, firefighters, who at minimum have basic emergency medical technician certification and may also be paramedics, are dispatched as first responders. Ambulances staffed by paramedics with advanced life support equipment are summoned either by their proximity to the call or on a rotation.

The goal is to train the paramedics to be as good as physicians when treating patients in the field. Andreas Grabinsky

Emergency responders must meet basic regulatory standards, but it is generally voluntary whether they equip their vehicles with the latest technologies and train their crews in the most up-to-date procedures and skills. A 2008 study led by Graham Nichol, director of the University of Washington-Harborview Center for Prehospital Emergency Care, found that survival rates for EMS-treated cardiac arrest in 10 major regions varied from a high of 16.3% in Seattle to a low of 3% in Alabama. New data for 2010, though not yet available by city, show the national average has been improving, according to Dr. Nichol.

Some ambulances are being fitted with machines that provide continuous chest compressions so paramedics can insert breathing tubes and perform other lifesaving procedures without pausing to restore breathing.

Another new device finding its way into some ambulances is a digital transmission system that speeds sophisticated electrocardiogram readings to the hospital so cardiac patients can get treated faster. When heart-attack victims require a balloon angioplasty, a procedure that opens blocked blood vessels, hospital staff often rush to get this done within 90 minutes, the time required to avoid heart-muscle damage. The transmission device is usually combined with a monitor to track the patient’s pulse, heart signs and breathing.

The new digital technology helped save the life of 43-year-old Robert Douglas, who passed out at his home in Cambridge, Mass., in August, feeling weak with chest pains radiating to his left arm. Paramedics from the Cambridge fire department and ambulance company Professional Ambulance and Oxygen Service Inc., known as Pro EMS, performed the ECG at Mr. Douglas’s home. Trained to interpret electrocardiograms, they transmitted to Mount Auburn Hospital images showing signs of a type of heart attack in which an artery is totally blocked by a blood clot. Doctors in the ER were able to get Mr. Douglas in for a balloon angioplasty within 42 minutes.

Pro EMS, a Cambridge, Mass., ambulance company, train to use hand-held ultrasound devices, which can assess
internal bleeding.

“Before this system, the communication was like a child’s game of telephone,” with paramedics and doctors at the hospital often not understanding each other’s verbal descriptions, says Todd Thomsen, an emergency physician at Mount Auburn. “Had this system not been in place or had there been other delays, Mr. Douglas would have had a worse outcome.” Mr. Douglas says he has recovered fully.

Pro EMS has been participating in a program at Emory University in Atlanta called the Cardiac Arrest Registry to Enhance Survival, or CARES, which the ambulance company says has helped it double its cardiac-arrest-survival rate in the last two years. CARES has been gathering data from 911 call centers, EMS providers and hospitals around the country since 2004 to compare results and to help communities improve emergency care.

At Pro EMS, which submits data to the CARES program as part of Cambridge’s fire-department EMS system, staff members undergo about five times the national standard of 72 hours of continuing education, refresher courses and recertification in CPR and advanced life-support skills, says chief executive Bill Mergendahl. The company has also purchased 16 sophisticated monitors, including the ECG systems, cardiac- and breathing-monitoring devices and defibrillators at a cost of $25,000 each. “It can get expensive to add new technologies to EMS, but we are improving outcomes that lead to savings in health care all the way down the line,” Mr. Mergendahl says.

Shown are paramedics undergoing
training to listen to lung sounds.

The San Francisco fire department, which began participating in CARES in 2009, trained all 1,400 of its staff last year in updated CPR and advanced cardiac-life-support techniques. The department purchased electronic monitors that provide visual feedback about the effectiveness of chest compressions, and it is using new airway tubes that are easier to insert without interrupting CPR.

Fire department captain Justin Schorr says the emergency survival rate in the city has risen over the two-year period. But the city wanted also to measure survival in another way—-for victims whose cardiac arrest was witnessed and someone, either a bystander or EMS staff, intervened with CPR or a defibrillator. “We focused on how well we did when we had the best chance to help someone,” he says, and results improved dramatically—from 9% to 23% over the period.

Researchers also are investigating possible new techniques to boost survival rates. For example, people admitted to the hospital ER at high risk for traumatic brain injury or hemorrhagic shock currently are given a dose of estrogen within two hours of injury, which has been shown to reduce dangerous inflammation. The Resuscitation Outcomes Consortium, a group of 10 regional centers based at the University of Washington that conducts clinical trials, plans to investigate whether estrogen given intravenously before the patient gets to the hospital would improve survival.

View original article: View Original WSJ Article

Here are excerpts from this related article released today:

February 9, 2012 — 11:54am ET | By Alicia Caramenico Designed to curb the “overuse and abuse” of costly emergency care, Washington’s hospitals will no longer receive Medicaid reimbursement for any “unnecessary” emergency room visits starting April 1, reported The Seattle Times.

In what could be the nation’s most restrictive Medicaid ER policy, the program would stop payment for roughly 500 conditions, ranging from the obviously nonemergent diaper rash to the more complicated hypoglycemic coma and chest pain, the article noted.

Emergency physicians and hospitals would be left to foot the bill for treating those conditions. But providers are urging lawmakers to halt the new policy, noting that Medicaid patients now will have to know what their diagnosis will be before going to the emergency department. “If we don’t know without an X-ray or CT scan, how can they know it?” asked emergency physician Nathan Schlicher, legislative chairman of the Washington Chapter of the American College of Emergency Physicians.

Meanwhile, emergency departments at Utah hospitals are in hot water with the state’s Medicaid program. They have allegedly overbilled Medicaid $22 million for charging emergency rates for non-emergency care between 2008 and 2009, reported The Salt Lake Tribune.

Utah’s Medicaid inspector general has not revealed the hospitals in question and has yet to place some on official notice.

View Original Article on Fierce Healthcare

View related links: 

Seattle Times: State Medicaid to quit paying for ER visits deemed unnecessary

Salt Lake Tribune: Most Utah hospitals on hook for overbilling Medicaid