HomeMy WebLinkAboutems-system-redesign-community-forum-1-18-22Alameda County
EMS System Redesign
Community Education, Engagement, and Input
Community Forum
1/18/2022
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Agenda 1.Housekeeping
& Welcome
2.EMS Panel
Presentation
3.Community
Q&A
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Everyone:
Please mute your microphone
when not speaking
Please ask your questions
in the Q&A function.
Why are we
here?
EMS System (9-1-1 Ambulance System) Redesign
•Equitable Access
•Fiscal Responsibility
•Appropriate Destination for All Patients
•Sustainability
Now is our chance to make our EMS system better!We need community feedback to accomplish that.
User experience, system partner feedback, and technical regulatory requirements inform the system redesign.
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EMS System:
By the
Numbers
5 9-1-1 ambulance transport operating areas
AlbanyBerkelyPiedmontAlamedaRest of County (Falck)
6 Fire/EMS dispatch centers
10 Fire Depts First Responder Advanced Life Support
14 Interfacility ambulance providers
15 9-1-1 receiving facilities 3 Trauma centers
7 STEMI centers
8 Stroke centers
2 Behavioral health facilities
160k 160,000 calls per year 50% of volume in Oakland
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Biggest
Challenges
Facing
EMS SystemStaffing
System StructureAddressing Community Needs
Hospital Saturation
Financial Stability One Pathway Model
Current 9-1-1 ambulance response
9-1-1 Called by
Citizen
Call Answered
and Triaged by
Dispatch
Available
Ambulance Sent
to Call
Transport to
Hospital
Patient Care
Transferred at
Hospital
EMS System Statistics
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Envisioned System
9-1-1 Called
by Citizen
Call
Answered
and Triaged
by Dispatch
Available
Resource
Sent
Dispatch
Center
Clinician
Telemedicine
Hospital Transport Alternative Destinations Referral
Guidance Referral Connection to Resources
Guidance Referral Connection to Resources
Call
Prevention
Through
Community
Education
Community
Paramedicine
Community
Paramedic
Follow Up
Reduce
Readmission
to Hospitals
Reduce
Repeated 911
Activations
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Community Experience-Scenario 1
Current System
•Ambulance and Fire Department dispatched.
•Patient transport to Hospital Emergency Room.
•Patient billed for transport and ER services.
Envisioned System
•Call triaged to telehealth or dispatch clinician.
•Symptoms assessed by RN or MD.
•Potential for prescription if needed.
•Referral for primary care services.
•Patient never leaves home.
•No transport or ER bill.
Individual calls 9-1-1 due to ear pain. Feels like previous ear infection. No
primary care provider. No transportation to get to hospital to be seen.
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Community Experience-Scenario 2
Current System
•Law Enforcement, Ambulance and Possibly Fire Dept responds.
•Individual potentially placed on 72-hour hold.
•Individual transported to John George or Emergency Room.
•Billed for transport and services at destination facility.
Envisioned System
•Telehealth or alternative specialized behavioral health response without law enforcement.
•Behavioral Health Assessment and use
of Community Health Record to determine links to resources.
•Explore alternatives to 72-hour hold.
•Ability to refer for services or transport
to alternate destinations such as clinics, crisis facilities, or to private behavioral health provider.
9-1-1 called for an adult experiencing a behavioral health crisis. There is
no evidence of violent behavior, ingestion, or injury requiring medical
intervention.
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EMS System
Financial Stability /
Service
Reimbursement
EMS Workforce Evolving Patient &
Community Needs
System Performance
Benchmarks Technology
•Leverage variety of
funding sources to
include IGT, ET3, and
potential fees or taxes
•Mechanism for
continual payer mix
and fiscal analysis
•Consider financial
impacts of different
model types
•A public model would
be ideal
•Focus on staff safety
and well-being
•Continue workforce
protections
•Greater workforce
input into equipment
and ambulances
•Increased legislative
engagement to
mitigate barriers and
create new paths to
serve community
•Provide better
integration of services
in a more accessible
way
•Provide focused
attention, education,
and training
pertaining to
populations requiring
specialty care
•Ability to evaluate
continuity of care
from phone call to
outcome
•Health Data Exchange
with Hospitals
•More fluid and
dynamic approach to
call prioritization
based on data
•Balance response
time vs. clinical need
vs. outcome
•↑ interoperability
•Operational
awareness of all
resources not just 911
•Telehealth
•Text to 911
•Dispatch Initiated
Triage and Navigation
by an imbedded
clinician
•Better communication
between field and
hospitals/alternative
destinations
System Partner Workgroup Recommendations & Priorities
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Redesign Timeline and Next Steps
MILESTONES TIMEFRAME
Continued Community Engagement/Education Through Mid-January 2022
Additional Input Accepted at: EMS.Redesign@acgov.org Through Mid Feb 2022
Consultant Process Complete by Mid Feb 2022
System Evaluation and Input Analysis February to April 2022*
RFP Development April to September 2022*
RFP Release October 2022*
Completion of RFP and Selection Process June 2023
New Ambulance Contract Starts July 2024
*Tentative Dates –Subject to Change as Needed 13
Questions -
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Thank
you for
your
time!
Questions?
Have input and
comments?EMS.Redesign@acgov.org
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