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.

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.

View original article..

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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.

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.

Behind the Flashing Lights.

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.

Ambulances get an upgrade..

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

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.

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.

Paramedics at 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.

Pro EMS – 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

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In an extraordinary development, Fierce Healthcare is reporting numerous articles where reimbursement is being cut off to hospitals for Non-Emergency visits to their Emergency Departments. Now the primary solution lies in determining if calls are true emergencies (emergent) or non-emergencies (non-emergent) and qualifying those calls. The best way to do that in a tested and proven way is via Decision Support Software (DSS). The best in the business is Odyssey.

For Solution Details Visit: view Odyssey DSS System

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

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The LifeBot Multi-Function Cart

The World’s First "Virtual Ambulance"

The LifeBot "Virtual Ambulance" cart design begins with the concept of Multi-Function, that a mobile telemedicine cart should be versatile enough to handle routine day-to-day procedures but capable enough to manage unexpected emergencies. One should be able to save money, ease budgets and not have to purchase multiple carts to fit multiple needs. Most importantly, it should save lives. One cart should "do-it-all" or be an "all-in-one" solution.

Featured is a flashing light system to clear the hallways similar to the way an ambulance clears the street. Its patent pending Boot In-Route™ feature means it is ready when you need it. Not only is the cart the most advanced, but it is also the very first Emergency Crash Cart with telemedicine, a "virtual ambulance" that may be easily deployed facility-wide.

LifeBot mobile telemedicine carts are the first and only carts designed to transmit "live" voice, video and full patient physiological data. This is the data usually acquired by complete physiological monitoring systems that are connected directly to the patient. Such parameters include ECG, Pulse Ox, NIBP, Invasive BP, and much much more. LifeBot carts utilize DREAMS™ technologies developed with the U.S. Military making them the most advanced in the world.

Physicians, intensivists, tele-nurses, or any specialist may use LifeBot lightweight tablet or desktop PCs to login to carts for instant remote "tele-presence". The same PCs may be used to login and be "virtually" on-the-scene to LifeBot equipped ambulances as well.

Physicians utilizing the LifeBot Slate tablet or Desktop PCs have remote control of the pan, tilt, zoom cameras next to the patient. This is just one of the many features of the LifeBot® DREAMS™ telemedicine system. The LifeBot robotic telemedicine crash cart system has numerous automated features so one may worry less about operating the cart system and focus more upon the quality of patient care.

DREAMS™ Ambulance to be Displayed at Gathering of Eagles

The same week LifeBot is displaying one of the original DREAMS™ Project Digital Ambulances at the Gathering of Eagles meeting in Dallas, TX February 24-25, 2012.

Both the ambulance and the cart systems utilize DREAMS™. LifeBot has acquired the exclusive world-wide rights to key telemedicine technologies including DREAMS™, a $14 million research project that has built the first Digital Telemedicine Ambulances. The project was the brain child of renowned Texas surgeon, Dr. James “Red” Duke, Jr. and was funded by the Telemedicine and Technology Research Center (TATRC) and U.S. Army Medical Research and Material Command (USAMRMC), Department of Defense agencies.

The Community Paramedicine Technology Guide

According to LifeBot CEO Roger Heath, "Entire states and nations internationally wish to deploy LifeBot DREAMS™ systems now. They know these advanced technologies can save lives, reduce workloads, and reduce risks and healthcare costs." Much of this has focused upon Community Paramedicine and delivery of primary care using mobile telemedicine. Both the cart and ambulance systems merge to form one uniform comprehensive system to meet both clinical and pre-hospital needs.

About LifeBot: LifeBot, a telemedicine solutions company, provides exclusive patented and military developed technologies for healthcare. These systems are used to send and receive live video, voice and patient vital-sign data transmissions primarily in support of heart, trauma and stroke victims.

LifeBot systems are also designed for management of major crises, disasters and emergencies by hospital and field based public safety emergency professionals and for the U.S. Military in battlefield operations. LifeBot integrates capabilities not inherent in today’s telemedicine systems, allowing the benefits of telemedicine, telehealth, and emergency preparedness objectives to be fully realized.

For more information : http://www.lifebot.us.com

Download the Multi-Function Crash Cart Brochure

Download the Community Paramedicine Technology Guide

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Odyssey on the LifeBot Slate

Odyssey and DREAMS™ Telemedicine Integrated

Odyssey is a critical component for Community Paramedicine and Mobile Healthcare delivery. It provides for fast, safe, more accurate patient assessments in just minutes. LifeBot has issued a new technology guide entitled “Responding to the Needs of Community Paramedicine”. The guide details how the DREAMS telemedicine system, developed with the U.S. Military, is combined with Odyssey to form a powerful combination. Now each may run on the 1.5 pound portable Hewlett Packard Slate 2.

Odyssey may be utilized at the priority dispatch level, in emergency departments, clinical patient non-emergency calls centers, and in telemedicine tele-hub operations. Extremely successful, it now occupies more than sixty percent of the market for General Practitioners in the U.K. handling more than 18 million calls over a 15 year period without any major legal issues. No other clinical decision support software can make these claims. Average patient assessment times may be as little as 5 or 6 minutes, virtually eliminating ‘over-triaging’. While simultaneously increasing efficiencies, it significantly reduces the risks associated with medical errors.

Why Decision Support Software?

The Odyssey DSS performs real-time patient assessments referencing over one million words of clinical data. The human brain simply cannot perform this function. But Odyssey can, and it can do this in just a few minutes. It provides a vivid list of differential diagnoses in just seconds. This not only speeds assessments and care, but significantly lowers risks and errors.

Fast accurate pre-hospital patient assessments are also required in the design of an EMS Mobile Healthcare System. So Odyssey is not just for use in dispatch tele-nursing. The use of DSS at both the dispatch and on-board pre-hospital vehicles provides for an early alert system for discerning whether one is dealing with an emergent or non-emergent situation. Errors and risk may be significantly reduced in both areas of use.

Odyssey is the first integral component for forging a pathway to millions in healthcare delivery savings in the EMS Mobile Healthcare model; to demonstrate significant savings similar to those already produced in the UK over many years.

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download Free Community Paramedicine Guide..

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"Multi-Function" to Save Both Money-Budgets and Lives.

A mobile telemedicine cart should be versatile enough to handle routine day-to-day procedures but capable enough to manage unexpected emergencies as well. One should not have to purchase multiple carts to fit multiple needs. One cart should "do-it-all"
..it should be an "all-in-one" solution.

The First "Virtual Ambulance™".

Now with the world’s most advanced Emergency Crash Cart, hospital Crash Cart Teams may deploy a cart where specialists may respond in seconds no matter where they are. They may simply login remotely to the cart system to be "virtually" on-the-scene.

Video-Conferencing is Not Telemedicine.

If one looks at the prominent telemedicine cart suppliers today, you may be shocked to find out most have little or no experience in the healthcare field at all; little knowledge of medical devices and acquiring critical life-saving physiologic information. Most are dedicated to performing video teleconferencing only and have a history as only audio visual specialists. view more..

Exclusive Telemedicine Technologies Developed with the U.S. Military.

LifeBot mobile telemedicine carts are the first and only carts designed to transmit "live" voice, video and full patient physiological data. This is the data usually acquired by complete physiological monitoring systems that are connected directly to the patient. Such parameters include ECG, Pulse Ox, NIBP, Invasive BP, and much much more. LifeBot carts utilize DREAMS™ technologies developed with the U.S. Military making them the most advanced in the world. view more..

The DREAMS™ system was conceived by renowned trauma surgeon James "Red" Duke, Jr. Dr. Duke and S. Ward Cassells, M.D, former Assistant Secretary of Defense (Medical Affairs, received the General Maxwell Thurman Award for these designs at the national meeting of the American Telemedicine Association.

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Responding to the
Needs of Community Paramedicine ^sm

EMS Mobile Healthcare Systems
LifeBot Technology Design Guide Kit

This is a comprehensive guide to the deployment of the Mobile Primary Care Unit (MPCU) for delivering primary care via EMS providers. This guide also is a detailed presentation on EMS Telemedicine and the prospects for using these technologies for substantially reducing healthcare costs.

Crucial to these systems is the use of Decision Support Software (DSS) to triage callers at the dispatch, call-center, and in actual field operations to determine if a call or a patient is an actual emergency (emergent) or non-emergency (non-emergent). Also reviewed is the crucial nature of EMS Telemedicine to “look inside” and acquire critical physiological data and transmit this to hospital physicians and specialists to save lives.

Download Free Paramedicine Technology Guide

The Role of Triage in Electronic Health Records (EHR)

The first step in building patient records is triage or teletriage. This is the start of initializing the whole process of managing electronic patient records. EHR (Electronic Health Record), EMR (Electronic Medical Record), and ePCR (electronic Patient Care Record) all need to be merged, but currently lack data interoperability or compatibility, particularly between hospital and prehospital based systems. Look to LifeBot® to be the first to fully integrate all of these and meet the NEMSIS 3.0 telemedicine multimedia integration standards. Stay tuned to this page for major developments in this area. This is why we are concentrating our efforts in this area at the beginning.

Triage and TeleTriage clinical Decision Support Software (DSS) are necessary ‘front ends’ to properly and safely manage health care patient record systems. A triage system is only as good as the amount of accurate clinical information it contains and how easily and quickly patient assessments may be executed. That’s why our teletriage systems, Odyssey, have the most highly developed databases for this purpose. This highly developed system contains more than one million words of clinical triage information for safe and accurate assessments. It can substantially lower risks and more clearly determine emergent or nonemergent status of a patient at the earliest stages of patient record management. Data may be transferred into ambulance or hospital record systems once responsive triage is executed.

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The DREAMS™ Digital Ambulance System.

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

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.

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 LifeBot Tablet.

We proved that because it works, and it works very well. Mike Koen

“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.

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.

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LifeBot has just been advised that R. Lee Heath will have his 33rd patent issue from the U.S. Patent Office. The new patent integrates crucial call management, Personal Emergency Response Systems (PERS) and resuscitation technologies that will only be available from LifeBot.

According to CEO, Roger Heath, "This new patent has major ramifications when applied to managing emergencies during telemedicine home remote monitoring. The majority of these patients are chronic and they are going to have an emergency arise. The patented system does away with the old mantra, “Hang up and dial 911.” because the last thing patients wish to do is disconnect a doctor or nurse during an emergency. There is no reason to hang-up on high-level life-saving medical expertise in the midst of an emergency. This could cost human lives."

"Most very large telemedicine firms have been investing billions in home remote monitoring and this undoubtedly will reduce healthcare costs. But, they seem to have "skipped over" or completely forgotten that most of these patients are going to have an emergency. This is inevitable.", states Heath, "So emergency management is critical to saving more lives and LifeBot® holds the exclusive patented technologies to make this possible."

When this patent is combined with Heath’s patented resuscitation technologies, this forms the basis for the most advanced home remote monitoring systems with emergency management "built-in" says, Heath.

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© LifeBot, LLC, 2012, All rights reserved. Patented. Additional patents pending.
LifeBot, LLC 2303 North 44th Street, Suite 14, Phoenix, AZ 85008 | Telephone: 877-466-1422
Date: 2011. | Post Permalink URL
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MPCU = Mobile Primary care Unit

A person would use lateral thinking when they want to move from one known idea to creating new ideas. Dr. Richard Reese

Lateral thinking is solving problems through an indirect and creative approach, using reasoning that is not immediately obvious and involving ideas that may not be obtainable by using only traditional step-by-step logic. . Lateral thinking is concerned with the movement of ideas. A person would use lateral thinking when they want to move from one known idea to creating new ideas. Edward de Bono defines four types of thinking tools:

• Idea generating tools that are designed to break current thinking patterns—routine patterns, the status quo
• Focus tools that are designed to broaden where to search for new ideas
• Harvest tools that are designed to ensure more value is received from idea generating output
• Treatment tools that are designed to consider real-world constraints, resources, and support.

November 6, 2011 – When I received the following email from Roger Heath, a biomedical engineer who is CEO of www. lifebot.us.com, I thought immediately of the concept of “lateral thinking,” arriving at innovation through direct and creative thinking.

Edward de Bono, MD, founder of a thinking institute in Malta, says the medical system is comprised of a horizontal landscape full of vertical holes with a specialists at the bottom of each hole. The problem is the vertical holes do not always intersect. The Internet, social media, and IT Techologies are in the process of connecting the holes. This is especially true in business-friendly environments, where entreprenuers and venture capitalists actively talk to each other.

The medical system is comprised of a horizontal landscape full of vertical holes with a specialists at the bottom of each hole. Edward de Bono, MD

The E-Mail:

We are focused on the ‘front door’ of the hospital, the Emergency Department, where roughly 80% of admissions occur. This is also where most medical record systems are initialized. We are working with Chief Dennis Murphy of the International Association of Fire Chiefs in this area. This is the “eye of the storm” of our projects, you might find this perspective fascinating because this may save cities tens of millions right away, even during healthcare reforms.

Simply put, this involves the prioritizing calls as emergent or non-emergent. Then non-emergency calls (30-60% at the 911 level) may be responded to with a lower cost Mobile Primary Care Unit (MPCU) that can elevate care, lower risks, and save substantial monies. To do this, one needs Decision Support Software (DSS) and mobile telemedicine. In the middle of healthcare reforms, major cities can respond by significantly lowering costs while providing higher levels of care at the same time. It’s a win-win situation, for both providers and patients.

I saw you reporting on Skype being used to qualify ED visits. I view this as potentially very risky, when done without Decision Support Software, like our Odyssey systems. Nurse teletriage was started in major U.S. city some years ago and resulted in a patient lawsuit that was successful and resulted in the complete over-haul of the fire department administration. This set back this concept for some years. Many are experimenting in this area without a great deal of understanding of the inherent risks. I did a post on our site that addresses this issue about using video conferencing only. See: Video Tele-Conferencing is NOT Telemedicine!

I brought the Odyssey DSS software from the UK because I could not find this in the US. It has done over 20 million assessments without a lawsuit. It has been developed over 15 years now. East Midlands Ambulance service has already been saving $11 million annually using the software for some years. I recently was at the Cleveland Clinic reviewing all of this at a very special meeting there regarding call center management. Triage and qualifying patients needs is becoming a central focus. See: DSS Tele-Triage

Prioritizing and coordinating care is the name of the game. It involves very carefully, and safely, matching patient needs to exactly the level of care required.

Reposted from Dr. Richard Reese’ “Medinnovation Blog” view full article

© LifeBot, LLC, 2012, All rights reserved. Patented. Additional patents pending.
LifeBot, LLC 2303 North 44th Street, Suite 14, Phoenix, AZ 85008 | Telephone: 877-466-1422
Date: 2011. | Post Permalink URL
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