WASHINGTON – The idea of talking to a nurse for a medical emergency when calling a 911 emergency system is not new. Indeed, the U.K. and Canada have very successful systems in place.

As cities struggle with budget constraints, the idea is gaining attention in the United States - most recently in Philadelphia, where its city controller recommended such a program in an April report as a way for emergency medical services units to respond to all critical emergencies.

"This is a growing phenomenon here," said Jonathan Linkous, CEO of the American Telemedicine Association. "It makes sense to do."

Linkous noted that the program delivers better care and saves money. Tele-nurses would have critical medical information that 911 dispatchers would not have, and would be able to offer intelligent medical advice, he said.

Thus far, Houston, Richmond and Seattle have implemented programs. Reported ROI include the avoidance of as many as 18,000 ambulance runs a year at a cost of $2.5 million annually, a reduction of about 8 percent. Linkous said that those numbers are fairly accurate. Fewer ambulance trips mean less use of the ED, which further drives up the cost savings, he pointed out.

Programs such as Ontario Telehealth have "proven track records and proven pathways on how to implement this type of program," he said.

The idea has been a talking point within the national healthcare reform dialogue, although nothing has been formulated at the national level, Linkous said. The concept is common among HMOs and large employer groups, but it's a recent phenomenon among cities.

While Houston, Richmond and Seattle did not seek guidance from the ATA, Linkous noted that his association would be glad to help cities with the implementation process.
 
In Philadelphia's case, some questions have arisen about how the programs work and what the telenurses' functions include. "It's important to set up protocols," Linkous said, to make the programs work smoothly.

The bottom line, he emphasized, "It will improve people's lives."