326 Mobile Integrated Telehealth: A Feasibility Study With Community Paramedicine Providers and Frequent 911 Users

Abstract

The San Diego Resource Access Program (RAP) is an example of an emergency medical services (EMS) based mobile integrated health (MIH) program with community paramedicine providers (CPPs) that has been shown to decrease health care costs and utilization among frequent 911 users. The use of telehealth in MIH with CPPs may provide an opportunity to connect a vulnerable population to providers in the out-of-hospital arena. CPP/RAP client pairs used an iPAD® on a commercial cellular carrier to establish HIPAA compliant telehealth visits with a remote physician connected to a wireless local area network(WLAN) or fixed wired internet connection. Qualitative and quantitative measures related to the telehealth visit were recorded based on the physician and CPP/RAP Client pair’s experience, in addition to recording the RAP Clients self reported social needs perception. A total of 20 telehealth face-to-face audio-video interactions were completed for a total time of 2 hours 48 minutes and 7 seconds. There were no dropped calls and total interruptions were minimal including audio 1.4% time and video interruptions 0.4% of total time. Both the physician and CPP/client pair had favorable overall satisfaction while RAP Clients also had a variety of perceived social needs. Out-of-hospital telehealth visits with CPPs and frequent 911 users using a commercial cellular carrier on an iPAD® with a remote provider on a WLAN or fixed wired internet connection are feasible with minimal interruptions and favorable satisfaction. This model could be used for a number of non-moving EMS applications including online medical direction.