MetroHealth and EMS Agencies Partner to Bring Virtual Care to the Ambulance

The MetroHealth System has partnered with three EMS agencies that provide advanced emergency life-saving care to bring virtual care via video visits with a doctor in the back of an ambulance.

The Emergency Triage, Treat and Transport (ET3) agreement between MetroHealth, the Brecksville Fire Department, Life Care Ambulance and North Central EMS, respectively, will empower patients by offering more focused care for older patients who call 911, whether that means a trip to the emergency room or a virtual visit with a MetroHealth emergency physician. The result will be better care for patients, fewer ambulance trips to the hospital and lower out-of-pocket costs.

“The advances in virtual care, amplified by our response to COVID19, allow MetroHealth’s Emergency Medicine physicians and our EMS partners to provide more complete care in certain 9-1-1 situations,” said MetroHealth EMS Division Director Thomas Collins MD, FACEP, FAEMS. “Ultimately, this helps patients stay at home and allows EMS to be more available to their community as a whole.”

“The ET3 model is the perfect example of what we believe virtual care can achieve for our patients,” said Michael Dalton, VP for the Virtual Care Enterprise at MetroHealth. “This model and virtual care empowers patients to get the most convenient and appropriate treatment in the setting that makes the most sense for them. This is a goal that all of our partners share.”

ET3 is a voluntary, five-year payment model from the Center for Medicare and Medicaid Innovation, that will provide greater flexibility to EMS agencies to address emergency health care needs of Medicare patients following a 911 call. ET3 will continue to allow for a transport to a hospital emergency department. But under this model, Medicare will also allow for partners to transport to an alternative destination partner, such as a primary care office, urgent care clinic, or a community mental health center, or initiate and facilitate treatment with a MetroHealth provider via virtual care.

The model will allow patients to access the necessary emergency services at the right time and place. As a result, the ET3 model aims to improve quality and lower costs by reducing avoidable transports to the ED and unnecessary hospitalizations following those transports. This means ED admissions may decrease but the acuity will be more appropriate.

“It is a tremendous honor to be working with MetroHealth on the implementation of a virtual care program,” said Brecksville Fire Chief Nick Zamiska. “This cutting-edge system will change the way emergency medical response is delivered in the field by our Fire/EMS personnel, yielding a higher standard of care for those we serve and protect.”

“As we forge ahead with the ET3 initiative, the sky is the limit!” said David Richards CEO at LifeCare Ambulance Inc., located in Elyria. “I can see where this could lead to more robust follow-up care after hospital discharges and community paramedicine.”

"The ability to provide virtual care during a 911 scene is an exciting opportunity for both patients and EMS providers as it helps to avoid unnecessary trips to the hospital or emergency room,” said Ashley Ballah, Director, North Central EMS, located in Erie County. “This keeps our patients safer and provides the most appropriate care for the people who call on us. North Central EMS is excited to partner with MetroHealth on this venture."

When a patient calls 911 and an EMS crew responds, typically that patient is taken to a hospital emergency department. Under ET3, the crew on the scene will complete an assessment of the patient to determine the immediate needs and what level of service is needed. That might still mean a trip to the emergency department. But they could also determine the patient’s condition can be treated at an alternative destination, such as urgent care or by their primary care physician. If the patient has a lower acuity condition that can be treated in place with a virtual visit, the medics will initiate such a video visit with a MetroHealth emergency physician.

The ET3 model is the latest program in The MetroHealth System’s virtual care offerings. It builds on the health system’s successful COVID hotline, Hospital in the Home model, Remote Patient Monitoring program enabled by CareSimple and the more than 480,000 virtual visits it provided in 2020.

This program began on January 25th.