New Mount Sinai Program Offers Telehealth for Non-Urgent Ambulance Calls

Led by the Mount Sinai Emergency Medical Services (EMS) in partnership with its Department of Emergency Medicine, a new program will provide telehealth options for patients who make 911 ambulance calls for non-urgent medical conditions.

Mount Sinai Health System is an academic medical system located in the New York Metro area with eight hospitals, 400 outpatient practices, almost 300 laboratories, and 43,000 employees. The system also includes a nursing school and a school of medicine and graduate education.

In a year, ambulances affiliated with Mount Sinai are dispatched to about 100,000 911 calls, the press release states. Of these calls, about 10 percent involve low-acuity patients with non-severe injuries, patients who need a medication refill, or patients who need transportation to an appointment.

Although these scenarios are non-urgent and do not require a visit to the emergency room, EMS must bring them to the hospital, according to the press release.

The new telehealth program, part of the federal pilot called Emergency Triage, Treat, and Transport (ET3), aims to provide an alternative solution through telehealth.

Under the Mount Sinai ET3 telehealth program, the initial steps will take place as usual. This involves a patient calling 911, followed by emergency medical technicians (EMTs) arriving and performing a patient assessment. If they conclude there is no need for emergency care, EMTs will remain on site and use tablets to connect to the command center. Then the patient will be connected virtually with an emergency medicine provider.

“ET3 is a great example of our health system moving from volume to value. We are delivering high-quality care at the lowest possible cost and we are excited about the opportunity that this presents for our health system,” said Nicholas Gavin, MD, vice chair of population health and clinical innovation for the Mount Sinai Health System and associate professor of emergency medicine at the Icahn School of Medicine at Mount Sinai, in the press release.

Two Mount Sinai ambulances are currently included in ET3, but by early next year, the health system plans to have all 16 of its ambulances linked to its seven emergency departments equipped with the telehealth service.

The ET3 telehealth pilot program is slated to continue for five years, according to the press release. 

The health system eventually aims to add services beyond telehealth to the program, including taking patients to an urgent care location, providing behavioral health services, and transporting patients to an alternate destination.

“This program is exciting because it’s a new and innovative way for EMS to deliver patient care where they are and connect them to services they need without having to come to the emergency department,” said Kevin Chason, DO, medical director for the Mount Sinai Hospital EMS group, in the press release. “911 is no longer equal to an emergency department visit. Now a mobile medical team can offer more patient-centered options, and in the future it could connect patients to services in addition to telemedicine or urgent care, such as bringing patients to places like a dialysis center or primary care office where the patient is known.”

A case study published in NEJM Catalyst in October found that the quality of virtual care provided to low-acuity patients was on par with care provided through standard in-person care in emergency departments.

Due to the COVID-19 pandemic, Stanford Health Care accelerated the launch of its plan to add virtual visits to clinical care. In this process, the system converted its emergency department Fast Track care unit to a virtual visit track (VVT).

Upon reviewing the care quality provided to patients through VVT, researchers found that the VVT group had lower lengths of emergency department stays and lower median return visit rates than the standard care group.