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[Guest guest]

isn't there a famous quote about lessons of history and repeating it???

From: phillipsdo@... & lt;phillipsdo@... & gt;

Subject: phillipsdo@... has sent you an article from

HoustonChronicle.com

To: texasems-l

Date: Friday, June 6, 2008, 5:13 AM

Sound familiar to the north Teaxs people

http://www.chron. com/disp/ story.mpl/ metropolitan/ 5819858.html

Houston to hire 'tele-nurses' as alternative to ambulances

By CAROLYN FEIBEL

Should you call an ambulance for a sprained wrist or child's fever? A

spider bite?

The medical consensus is no, but every year thousands of people in the

Houston area dial 911 for non-emergencies.

Hoping to cut back on the number of ambulances responding to

non-emergency calls, the City Council voted Wednesday to hire

round-the-clock " tele-nurses " to work with 911 dispatchers.

For callers who do not have a true emergency, a nurse will offer

first-aid advice over the phone, or help them find a clinic or doctor.

The Houston Fire Department responds to about 750 emergency medical

calls a day.

" In a large percentage of cases, when we get there, the patient didn't

even want to go to the hospital, " said Dr. Persse, the city's

director of Emergency Medical Services. " Maybe they just wanted some

advice, get their blood pressure taken. "

Some people call 911 because they have no health insurance or no

transportation to the hospital. Others have insurance but do not know

how to get after-hours care or cannot judge how serious a problem may

be.

Until now, the default solution has been to send an ambulance. That

costs taxpayers and also can cost the patient: An ambulance ride to the

ER costs $415, plus $7.50 per mile. That's before the hospital bill.

" That's a waste of resources, and it also could endanger somebody who

really does need an emergency response, " Mayor Bill White said.

The city will spend $6.8 million over five years on a contract with the

County Healthcare Alliance. The nonprofit group has

subcontracted with San -based CareNet, which will provide at

least two nurses around the clock.

If primary care is needed, the nurses can refer callers to

health-access " navigators " at the nonprofit Gateway to Care. The

navigators will help 911 callers make an appointment at clinics in

Houston and can help arrange transportation.

Treated like a cab ride

Houston is among the first cities to try tele-nurses for 911 calls.

Richmond, Va., has a similar program, Persse said.

Capt. Alan Nollkamper, who worked for more than 12 years as a Houston

paramedic, said flu season is the worst for unnecessary runs.

" It comes in as a 'breathing difficulty' call, " Nollkamper said. " We

get there and realize the patient has a low-grade fever or congestion.

Maybe they need antibiotics, but they don't need our services. "

Nollkamper said people call ambulances for minor cuts, sunburns or even

because they need prescriptions refilled.

" It's a 911 ambulance, but it's treated like a taxicab, " said Sebastian

Chavez, a paramedic in the Sunnyside and South Park neighborhoods.

" You'll get told many times on the street, 'just do your job and take

me to the hospital.'

" They're taking away a paramedic unit from somebody who may need a

paramedic unit. "

City officials did not provide an estimate but said they were certain

the program will save money in the long run.

At first, the nurses will handle about 20 calls a day, but that could

grow to 75 or 100 calls a day.

More than half of emergency-room visits by County residents in

2006 were for problems that could have been treated in a doctor's

office, according to a study by UT's School of Public Health. The

estimated cost was $50 million, the study said.

Only 32 percent of those ER visitors had no health insurance. The rest

had private or federal coverage but may not have known how to use it

efficiently, said Love, executive director of the County

Health Care Alliance.

" The whole idea is to educate people, help them get self-care when

appropriate, " Love said. " It's just about getting these folks to

connect to what we call a 'medical home,' a regular source of care

where someone has your medical records there. "

There is little danger that a true emergency will get diverted to a

phone nurse, officials said.

" If, at any time during the call, the nurse feels the call has shifted

and is of an emergency nature, then the call is immediately directed

back to (Houston Emergency Center) and an ambulance is dispatched, "

said HFD Capt. Dupont.

She added that working with the nurse will be voluntary. If at any time

a caller wants an ambulance, it will be dispatched, she said.

Fully insured

The alliance is purchasing additional liability insurance, and CareNet,

the company providing the nurses, also carries insurance of $3 million

per claim, Love said.

More than 30 percent of County residents are uninsured, compared

with 24 percent in Texas and 15 percent nationwide.

The reasons are manifold, Love said. Texas has strict income limits for

Medicaid eligibility. A high proportion of Texans work for small

businesses, which are less likely to offer insurance. Undocumented

residents also contribute to the uninsured rates.

carolyn.feibel@ chron.com

Brought to you by the HoustonChronicle. com

[Guest guest]

Why nurses, not paramedics? What training does the average nurse have that

would enable him or her to determine over the phone whether or not there is a

true medical emergency that needs transport?

Dallas tried this years ago with disastrous results.

Maybe nurse/paramedics would be the thing, but they had better choose their

nurses carefully or some bad mistakes will be made.

Gene Gandy

>

> Sound familiar to the north Teaxs people

>

> http://www.chron.http://wwhttp://wwwhttp://www.chhttp://www.c

>

> Houston to hire 'tele-nurses' as alternative to ambulances

> By CAROLYN FEIBEL

>

> Should you call an ambulance for a sprained wrist or child's fever? A

> spider bite?

>

> The medical consensus is no, but every year thousands of people in the

> Houston area dial 911 for non-emergencies.

>

> Hoping to cut back on the number of ambulances responding to

> non-emergency calls, the City Council voted Wednesday to hire

> round-the-clock " tele-nurses " to work with 911 dispatchers.

>

> For callers who do not have a true emergency, a nurse will offer

> first-aid advice over the phone, or help them find a clinic or doctor.

>

> The Houston Fire Department responds to about 750 emergency medical

> calls a day.

>

> " In a large percentage of cases, when we get there, the patient didn't

> even want to go to the hospital, " said Dr. Persse, the city's

> director of Emergency Medical Services. " Maybe they just wanted some

> advice, get their blood pressure taken. "

>

> Some people call 911 because they have no health insurance or no

> transportation to the hospital. Others have insurance but do not know

> how to get after-hours care or cannot judge how serious a problem may

> be.

>

> Until now, the default solution has been to send an ambulance. That

> costs taxpayers and also can cost the patient: An ambulance ride to the

> ER costs $415, plus $7.50 per mile. That's before the hospital bill.

>

> " That's a waste of resources, and it also could endanger somebody who

> really does need an emergency response, " Mayor Bill White said.

>

> The city will spend $6.8 million over five years on a contract with the

> County Healthcare Alliance. The nonprofit group has

> subcontracted with San -based CareNet, which will provide at

> least two nurses around the clock.

>

> If primary care is needed, the nurses can refer callers to

> health-access " navigators " at the nonprofit Gateway to Care. The

> navigators will help 911 callers make an appointment at clinics in

> Houston and can help arrange transportation.

>

> Treated like a cab ride

>

> Houston is among the first cities to try tele-nurses for 911 calls.

> Richmond, Va., has a similar program, Persse said.

>

> Capt. Alan Nollkamper, who worked for more than 12 years as a Houston

> paramedic, said flu season is the worst for unnecessary runs.

>

> " It comes in as a 'breathing difficulty' call, " Nollkamper said. " We

> get there and realize the patient has a low-grade fever or congestion.

> Maybe they need antibiotics, but they don't need our services. "

>

> Nollkamper said people call ambulances for minor cuts, sunburns or even

> because they need prescriptions refilled.

>

> " It's a 911 ambulance, but it's treated like a taxicab, " said Sebastian

> Chavez, a paramedic in the Sunnyside and South Park neighborhoods.

> " You'll get told many times on the street, 'just do your job and take

> me to the hospital.'

>

> " They're taking away a paramedic unit from somebody who may need a

> paramedic unit. "

>

> City officials did not provide an estimate but said they were certain

> the program will save money in the long run.

>

> At first, the nurses will handle about 20 calls a day, but that could

> grow to 75 or 100 calls a day.

>

> More than half of emergency-room visits by County residents in

> 2006 were for problems that could have been treated in a doctor's

> office, according to a study by UT's School of Public Health. The

> estimated cost was $50 million, the study said.

>

> Only 32 percent of those ER visitors had no health insurance. The rest

> had private or federal coverage but may not have known how to use it

> efficiently, said Love, executive director of the County

> Health Care Alliance.

>

> " The whole idea is to educate people, help them get self-care when

> appropriate, appropriate,<wbr> " Love said. " It's just about gett

> connect to what we call a 'medical home,' a regular source of care

> where someone has your medical records there. "

>

> There is little danger that a true emergency will get diverted to a

> phone nurse, officials said.

>

> " If, at any time during the call, the nurse feels the call has shifted

> and is of an emergency nature, then the call is immediately directed

> back to (Houston Emergency Center) and an ambulance is dispatched, "

> said HFD Capt. Dupont.

>

> She added that working with the nurse will be voluntary. If at any time

> a caller wants an ambulance, it will be dispatched, she said.

>

> Fully insured

>

> The alliance is purchasing additional liability insurance, and CareNet,

> the company providing the nurses, also carries insurance of $3 million

> per claim, Love said.

>

> More than 30 percent of County residents are uninsured, compared

> with 24 percent in Texas and 15 percent nationwide.

>

> The reasons are manifold, Love said. Texas has strict income limits for

> Medicaid eligibility. A high proportion of Texans work for small

> businesses, which are less likely to offer insurance. Undocumented

> residents also contribute to the uninsured rates.

>

> carolyn.feibel@...

>

> Brought to you by the HoustonChronicle. Br

>

**************

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[Guest guest]

Sound familiar to the north Teaxs people

http://www.chron.com/disp/story.mpl/metropolitan/5819858.html

Houston to hire 'tele-nurses' as alternative to ambulances

By CAROLYN FEIBEL

Should you call an ambulance for a sprained wrist or child's fever? A

spider bite?

The medical consensus is no, but every year thousands of people in the

Houston area dial 911 for non-emergencies.

Hoping to cut back on the number of ambulances responding to

non-emergency calls, the City Council voted Wednesday to hire

round-the-clock " tele-nurses " to work with 911 dispatchers.

For callers who do not have a true emergency, a nurse will offer

first-aid advice over the phone, or help them find a clinic or doctor.

The Houston Fire Department responds to about 750 emergency medical

calls a day.

" In a large percentage of cases, when we get there, the patient didn't

even want to go to the hospital, " said Dr. Persse, the city's

director of Emergency Medical Services. " Maybe they just wanted some

advice, get their blood pressure taken. "

Some people call 911 because they have no health insurance or no

transportation to the hospital. Others have insurance but do not know

how to get after-hours care or cannot judge how serious a problem may

be.

Until now, the default solution has been to send an ambulance. That

costs taxpayers and also can cost the patient: An ambulance ride to the

ER costs $415, plus $7.50 per mile. That's before the hospital bill.

" That's a waste of resources, and it also could endanger somebody who

really does need an emergency response, " Mayor Bill White said.

The city will spend $6.8 million over five years on a contract with the

County Healthcare Alliance. The nonprofit group has

subcontracted with San -based CareNet, which will provide at

least two nurses around the clock.

If primary care is needed, the nurses can refer callers to

health-access " navigators " at the nonprofit Gateway to Care. The

navigators will help 911 callers make an appointment at clinics in

Houston and can help arrange transportation.

Treated like a cab ride

Houston is among the first cities to try tele-nurses for 911 calls.

Richmond, Va., has a similar program, Persse said.

Capt. Alan Nollkamper, who worked for more than 12 years as a Houston

paramedic, said flu season is the worst for unnecessary runs.

" It comes in as a 'breathing difficulty' call, " Nollkamper said. " We

get there and realize the patient has a low-grade fever or congestion.

Maybe they need antibiotics, but they don't need our services. "

Nollkamper said people call ambulances for minor cuts, sunburns or even

because they need prescriptions refilled.

" It's a 911 ambulance, but it's treated like a taxicab, " said Sebastian

Chavez, a paramedic in the Sunnyside and South Park neighborhoods.

" You'll get told many times on the street, 'just do your job and take

me to the hospital.'

" They're taking away a paramedic unit from somebody who may need a

paramedic unit. "

City officials did not provide an estimate but said they were certain

the program will save money in the long run.

At first, the nurses will handle about 20 calls a day, but that could

grow to 75 or 100 calls a day.

More than half of emergency-room visits by County residents in

2006 were for problems that could have been treated in a doctor's

office, according to a study by UT's School of Public Health. The

estimated cost was $50 million, the study said.

Only 32 percent of those ER visitors had no health insurance. The rest

had private or federal coverage but may not have known how to use it

efficiently, said Love, executive director of the County

Health Care Alliance.

" The whole idea is to educate people, help them get self-care when

appropriate, " Love said. " It's just about getting these folks to

connect to what we call a 'medical home,' a regular source of care

where someone has your medical records there. "

There is little danger that a true emergency will get diverted to a

phone nurse, officials said.

" If, at any time during the call, the nurse feels the call has shifted

and is of an emergency nature, then the call is immediately directed

back to (Houston Emergency Center) and an ambulance is dispatched, "

said HFD Capt. Dupont.

She added that working with the nurse will be voluntary. If at any time

a caller wants an ambulance, it will be dispatched, she said.

Fully insured

The alliance is purchasing additional liability insurance, and CareNet,

the company providing the nurses, also carries insurance of $3 million

per claim, Love said.

More than 30 percent of County residents are uninsured, compared

with 24 percent in Texas and 15 percent nationwide.

The reasons are manifold, Love said. Texas has strict income limits for

Medicaid eligibility. A high proportion of Texans work for small

businesses, which are less likely to offer insurance. Undocumented

residents also contribute to the uninsured rates.

carolyn.feibel@...

Brought to you by the HoustonChronicle.com