SAN ANTONIO – The San Antonio Fire Department traditionally has not had much flexibility when responding to 911 calls for medical assistance.
“We either took you to the hospital, or we didn’t. That was it,” Assistant Chief Bryan Norris said.
But after the San Antonio City Council’s approval on Tuesday, SAFD will be able to get reimbursed for using the Emergency Triage, Treat and Transport model, or ET3, on medical calls beginning Jan. 11.
The ET3 model will allow SAFD to take patients to urgent care centers rather than hospital emergency rooms, have a physician or advanced practice practitioner come to the scene to treat the patient, or even connect them to a doctor with telemedicine.
“Everybody knows it’s pretty expensive to go to the ER at a hospital,” Norris said. “However, if I can take care of your problem at home for a $30 fee versus a $1,000 fee, that’s a benefit to the patient.”
A separate but complementary program has already been underway since October for dispatchers to field low-urgency calls -- such as someone who calls with minor flu symptoms -- with video chats, preventing EMS personnel from having to make unnecessary calls.
The department had to apply to the Centers for Medicare and Medicaid Services to participate in E3T. Though it’s aimed at Medicare Fee-for-Service patients, SAFD will provide the same options to all 911 callers.
“So one of the things we try not to do in the San Antonio Fire Department, for sure, is we try not to do what a lot of people call ‘insurance triage.’ So we want you to feel free to call and get 911 services and medical services if you need them,” Norris said.
The department has already been triaging services to a certain extent since Oct. 19 when it began using a new app, GoodSam, which could be used to deal with minor emergencies that might not warrant an actual EMS visit.
Dispatchers can send a link to the 911 caller, which will open a web-based video chat. Unlike a typical video chat, though, SAFD says GoodSam can measure the caller’s vitals.
“So we’ll be able to see your pulse rate. We can see you breathing. We can see your -- the color, you know, if you’re becoming diaphoretic or if you’re becoming pale or whatever and do a true assessment versus just talking to somebody on the phone,” Norris said.
The department says the app has already saved them an average of nine runs a day, which means the EMS and fire units that would have made them are still available for more severe emergencies.
“There’s nothing more frustrating to being at a very, you know -- somebody has an infected hair follicle, and a heart attack comes in down the street. Well, I can’t just break off of that to go on there,” Norris said.
SAFD says the GoodSam app also allows its firefighters to cut down on potential COVID-19 exposure.