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Call 911 in Other Areas

When you call 911, you reach your local dispatch.  This is a problem with medical staff who have patient emergencies on the phone or telehealth, because 911 needs to be activated where the patient is located.  The problem is worsened by the lack of United States 911 infrastructure for interstate communication.  Telemedicine911 software allows medical staff to directly call and text 911 for patients in any city or state in the U.S. for optimal hand-off.

Hand-off Care in Writing and Verbally

Transition of Care and hand-off in writing and verbally creates effective communication and coordination of care.1,2,3,4  Effective patient hand-off has been shown to reduce medical error by 23% and reduce preventable adverse events by 30%2.  Asking patients to call 911 themselves is not an effective handoff.  Telemedicine911 software allows medical staff to text critical patient information to the same 911 dispatcher they talk to.

Buy Now and be ready

 

How Our Hand-off Works

Step 1

Enter Patient Information

Enter your patient’s name, ALS or BLS response, and facility needed.  When you call 911 this will be sent to the 911 dispatcher handling the case.

Step 2

Enter Location

Enter the patient’s location and the software validates the location to ensure the ambulance goes to the correct address, room, and floor.

Step 3

Call 911

Directly call the 911 dispatcher where your patient is located through the Telemedicine911 software on your computer or mobile phone. Talk to the dispatcher to coordinate care.  

Software Demo

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Improve Transition Of Care from the telehealth setting to the ambulance / emergency department setting.  

Provide Standard Telemedicine Emergency Hand-off Information in Written and Verbal form.

Written patient name and sender call back number

Level of care needed: ALS, BLS, Police, or Fire

Name of hospital or type of facility needed

Address and on-site instructions

Free Text for other important information 1,2,3

Telemedicine911 Use Cases

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Psychiatric Crisis

A depressed female is on a laptop video consult with Dr. Chiu.  She says she wants to kill herself by stepping in front of a train. Despite video de-escalation measures, she says again she will kill herself and closes the laptop.  Dr. Chiu uses Telemedicine911 and coordinates both EMS and Police to the route nearest the train tracks and met her in transit.  Over 200 people died in 2018 in the New York metro area from completed suicide by train tracks alone.  Suicide is the 10th leading cause of death in the United States and a top use of the Telemedicine911 system.

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Home Monitoring​

A 55-year-old female was being evaluated for COVID-19 exposure and monitored on mobile cardiac telemetry (MCT).  She was being managed by Nurse Practitioner Macadams who was 130 miles away.  The patient had a history of cardiac arrhythmia and poor compliance with beta blockers.  NP Macadams noticed an alarm on the remote monitor and started a video conference with the patient.  The patient was in full supraventricular tachycardia (SVT).  She had no chest pain but felt light headed.  NP Macadams activated Telemedicine 911 with COVID-19 precautions and contacted Dr Chiu.  Paramedics arrived in minutes with PPE protection for COVID and initiated treatment on site with an IV, fluids, and first dose of beta blockers.  The patient was transported to the ED where her heart rate normalized.


 

After Hours Phone Call

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A 74 year old male calls your office because he is having epigastric and chest pains.  The after hours answering service gets you on the phone.  The patient says he usually has pain when he eats spicy foods, but this time it has lasted longer and feels more like a squeeze.  Antacids were not helping.  He has a history of CAD.  His niece insisted he call his doctor.  You ask him to call 911, the patient agrees, and you hang up. 

Thirty minutes later you called him back to see how things are going.  His niece picked up and said he did not call 911 because he was afraid of getting COVID at the hospital and did not want to go.  You talk to the patient again and activate Telemedicine 911.  He arrives in the ED and is shown to have an inferior wall MI. 

When patients have chest pain, they hesitate to call 911 for an average of 3.5 hours.  Even if you tell the patient to call 911 and hang up, they still hesitate.  Telemedicine911 allows you to talk directly with 911 dispatchers and direct them to send your patients to cardiac centers with cath labs rather than the closest emergency room which may not be equipped. 

Time is heart muscle.  Your Telemedicine911 response gets the patient to the right facility without hesitation.  If the patient were in your office, you would coordinate 911, not your patient.  Take control of the situation

This same doctor has had 3 patients die in 2020 due to reluctance to call 911 and go to the hospital.

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Radiology Callback  

A 42 year old patient was seen in the Emergency Department for a headache after a fall.  The CT Head was normal as per tele-radiology.  The patient left and went home to a different city.  The next day on follow up the patient was found to have a subdural hematoma which was missed on CT.  When the doctor called, the patient’s headache had worsened and he was somnolent.

  He coordinated the emergency with telemedicine 911 to take the patient to their affiliated facility with Neurosurgical ORs.  The patient completed the procedure within the hospital system, had a short post op stay, and was discharged home to follow up.  About 30% of malpractice cases originate from a communication breakdown with nearly half in the ambulatory setting.5 Nearly 35% of EMS and 911 malpractice dollars lost are due to claims related to medical negligence and all parties may be at fault.6  In an established provider patient relationship, failure to activate 911 in a remote emergency may be considered breach of duty and negligence.

 “Professional to Professional communication without intermediaries is better, faster, and provides the best outcomes.  When doctors hang-up and ask the patient to call 911, continuity of care stops, and there is uncertainty if the patient provided the best information to or even called 911 at all.  Patient 911 call hesitancy has been shown to delay 911 activation over 3.5 hours. Doctors should maintain control of emergencies and properly hand-off care.”  

-Alexander Chiu, MD, FACEP

Telemedicine911 Use Cases

The cases below are common real patient cases.  Names, images, and details have been changed for privacy purposes.

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Psychiatric Crisis

A depressed female is on a laptop video consult with Dr. Chiu.  She says she wants to kill herself by stepping in front of a train. Despite video de-escalation measures, she says again she will kill herself and closes the laptop.  Dr. Chiu uses Telemedicine911 and coordinates both EMS and Police to the route nearest the train tracks and met her in transit.  Over 200 people died in 2018 in the New York metro area from completed suicide by train tracks alone.  Suicide is the 10th leading cause of death in the United States and a top use of the Telemedicine911 system.

image11.jpg?resize=768,512&ssl=1.jpg

Home Monitoring​

A 55-year-old female was being evaluated for COVID-19 exposure and monitored on mobile cardiac telemetry (MCT).  She was being managed by Nurse Practitioner Macadams who was 130 miles away.  The patient had a history of cardiac arrhythmia and poor compliance with beta blockers.  NP Macadams noticed an alarm on the remote monitor and started a video conference with the patient.  The patient was in full supraventricular tachycardia (SVT).  She had no chest pain but felt light headed.  NP Macadams activated Telemedicine 911 with COVID-19 precautions and contacted Dr Chiu.  Paramedics arrived in minutes with PPE protection for COVID and initiated treatment on site with an IV, fluids, and first dose of beta blockers.  The patient was transported to the ED where her heart rate normalized.


 

iStock_000003657245_Large-3.jpg?w=576&ss

After Hours Phone Call

A 74 year old male calls your office because he is having epigastric and chest pains.  The after hours answering service gets you on the phone.  The patient says he usually has pain when he eats spicy foods, but this time it has lasted longer and feels more like a squeeze. 

Antacids were not helping.  He has a history of CAD.  His niece insisted he call his doctor.  You ask him to call 911, the patient agrees, and you hang up. 

Thirty minutes later you called him back to see how things are going.  His niece picked up and said he did not call 911 because he was afraid of getting COVID at the hospital and did not want to go.  You talk to the patient again and activate Telemedicine 911.  He arrives in the ED and is shown to have an inferior wall MI. 

When patients have chest pain, they hesitate to call 911 for an average of 3.5 hours.  Even if you tell the patient to call 911 and hang up, they still hesitate.  Telemedicine911 allows you to talk directly with 911 dispatchers and direct them to send your patients to cardiac centers with cath labs rather than the closest emergency room which may not be equipped. 

Time is heart muscle.  Your Telemedicine911 response gets the patient to the right facility without hesitation.  If the patient were in your office, you would coordinate 911, not your patient.  Take control of the situation

This same doctor has had 3 patients die in 2020 due to reluctance to call 911 and go to the hospital.

Screen-Shot-2020-11-03-at-9.04.01-PM-1.p

Radiology Callback  

A 42 year old patient was seen in the Emergency Department for a headache after a fall.  The CT Head was normal as per tele-radiology.  The patient left and went home to a different city.  The next day on follow up the patient was found to have a subdural hematoma which was missed on CT.  When the doctor called, the patient’s headache had worsened and he was somnolent.

  He coordinated the emergency with telemedicine 911 to take the patient to their affiliated facility with Neurosurgical ORs.  The patient completed the procedure within the hospital system, had a short post op stay, and was discharged home to follow up.  About 30% of malpractice cases originate from a communication breakdown with nearly half in the ambulatory setting.5 Nearly 35% of EMS and 911 malpractice dollars lost are due to claims related to medical negligence and all parties may be at fault.6  In an established provider patient relationship, failure to activate 911 in a remote emergency may be considered breach of duty and negligence.

  1. The Joint Commission, “Inadequate Hand-off communication” Sentinel Event Issue 58, 2017

  2. A. Starmer et al, “Changes in Medical Errors after Implementation of a Handoff Program.”  New England Journal Of Medicine, 2014 Nov; 371:1803-1812

  3. Centers for Medicare & Medicaid Services, “Transitions of Care (TOC) Measures in Stage 2 Summary of Care Objective” 2014

  4. Joint Commission Center for Transforming Healthcare; “Hand-off Communications Targeted Solutions Tool” 

  5. Brown TW, McCarthy ML, Kelen GD, Levy F. An epidemiologic study of closed emergency department malpractice claims in a national database of physician malpractice insurers. Acad Emerg Med. 2010;17:553-560.

  6. CRICO Strategies. Malpractice risk in communication failures; 2015 Annual Benchmarking report, Boston Massachusetts: The risk management foundation of the Harvard Medical Institutes, Inc, 2015.  

  7. Colwell et al, “Claims against a paramedic ambulance service: a ten-year experience”  J Emerg Med, Nov-Dec 1999  17(6):999-100

Quality Hand-off has been shown to;

 

Decrease Medical Error by 23% with standardized hand-off 2

Reduce preventable adverse events which lead to harm by 30%

Reduce near misses by 21% 2