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VCU Health, EMS providers using telehealth to respond to COVID-19 cases in rural Virginia

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A pilot program is connecting VCU emergency medicine physicians with first responders in three counties, helping to lower strain on busy EMS and hospital systems.

When emergency medical service agencies in Virginia’s rural Essex, Westmoreland or Richmond counties respond to a call for a patient with COVID-19 symptoms, first responders are now able to communicate in real time with VCU Health emergency medicine physicians using telehealth technology. VCU Health physicians are able to evaluate the patient and discuss the risks and benefits of transport to a hospital versus remaining in the home.

The pilot program — the first of its kind in Virginia — is allowing the EMS agencies and VCU Health to rapidly make decisions about what is best for the patient, while also lowering the chance of additional exposure and reducing strain on busy EMS agencies and hospitals’ emergency departments that are facing rising numbers of COVID-19 patients.

“These efforts will help lessen emergency department surge visit volumes, EMS provider personal protective equipment use, EMS provider exposure time with potential COVID-19 patients, and the time an ambulance is out of service for its community,” said Harinder Dhindsa, M.D., associate professor and interim chair of the Department of Emergency Medicine in the VCU School of Medicine, and medical director of VCU Critical Care Transport.

“VCU Health Department of Emergency Medicine remains committed to supporting our EMS partners during this crisis with innovative solutions to an evolving problem,” Dhindsa said.

The EMS agencies connect with VCU Health via a HIPAA-compliant communications platform, called Pulsara, that is approved by the VCU Health System and enables video chat between the VCU emergency medicine physician, the patient and the EMS provider.

The program was designed by Benjamin Nicholson, M.D., a former flight paramedic with VCU Health who is now an EMS Fellow with VCU Health’s emergency department, and Lisa Dodd, D.O., an assistant clinical professor in the Department of Emergency Medicine who also serves as the operational medical director for the partner EMS agencies.

Blake Byrd, assistant chief of Westmoreland EMS, said the pilot program changes the dynamic of rural EMS, which is resource limited and volume heavy.

“As an agency that has been exploring telemedicine for some time, this propels us into a platform that allows for direct physician consult on the scene with existing infrastructure,” Byrd said. “By having this capability in the field with our providers, we have the potential to screen patients that meet a pre-determined protocol and potentially keep our limited resources available for additional volume that may result from COVID-19. This capability is crucial for our system from both a management and pre-hospital care perspective.”

The program fits squarely with the mission of the VCU Health System, said Kathy Baker, Ph.D., nursing director of resource management and emergency services for VCU Heath.

“Our goal is to serve our community, our patients and our employees,” she said. “This innovative approach allows us to do all three of those things. It’s an example of how VCU Health sparks innovation and creativity in health care.”

The program, which launched last week, is an example of the ways in which VCU Health and local EMS agencies are working together to serve patients and the community, particularly in a time of crisis, Dhindsa said. The team is considering expanding the program to additional Virginia localities and perhaps even for patients with conditions other than COVID-19.