Why can’t I activate emergencies just by calling the regular 911 number?
911 was not built for Telemedicine. When you call 911, you will reach your own local 911 dispatch. You will not reach the 911 of where your patient is located. Here’s why. The United States 911 system is separated into about 6,000 centers known as Public Safety Access Points (PSAPs). Each PSAP has a jurisdiction map which it covers.
The below map is an example of New Jersey’s jurisdictions for each PSAP from 2015. You can see below there are 15 different PSAPs in New Jersey which some cover many cities and counties and some only
For traditional 911 landline calls, when you call 911 you will reach the PSAP which corresponds to the address on the billing records of the land line phone. A PSAP may have 20 dispatch agents who take calls in order and have this address displayed on their screens. The PSAP dispatch agent station is connected with the local Fire, Police, and Emergency Medical Services in the jurisdiction of the PSAP. Every month or so a few PSAPs in the United States either close down or open and the maps change which is why the New Jersey map above has already expired.
The great thing about the system is that the local police, fire, and EMS have CAD systems which track the real time location of every vehicle, track whether or not each vehicle is available or on a job with an emergency, and how far they are from the locations in the zone. The example illustratively shows how a CAD system can identify an ambulance not available (in red) and ambulances which are available (in green). It shows a person in an emergency and three ambulances within driving distances of 3 minutes, 6 minutes, and 7 minutes of the patient. It also tracks the helicopters which can respond to emergencies too. The national EMS response time is a remarkable 8 minutes on average due to the professionals being stationed and ready around the country. However, to use this great system you still need to go through the 911 call.
What’s so bad about the system? First off, 911 was not built for mobile phones. The solution mobile carriers came up with was a patch on the traditional system rather than an overhaul of the infrastructure. When you call 911 from your mobile phone, it uses the location of the tower to locate a corresponding PSAP. But, the tower your mobile phone sends signal to may be in a different PSAP jurisdiction than you are. Also, the location that is sent is the radio location of your phone, not the address, GPS or other more accurate location information. Today, the most common device used to call 911 is the mobile phone. Yet, the same system is in place with imperfect location identification and PSAP assignment. This is why the PSAP dispatch agent will now answer the call with “911, where is your emergency?” because they really don’t know where you are. Standard mobile apps for ordering car taxis or pizza delivery have better technology and are more accurate with location than 911 mobile calls. By 2021 the FCC is requiring mobile phone carriers to be only 80% accurate for mobile 911 calls, today they are only required to be 40% accurate. For an emergency such as heart attack or shooting, what location accuracy would you expect?
In 2014 the FCC deployed the “Text-to-9-1-1” program which enables mobile carriers to send 911 texts to PSAPs who request them. But, due to the lack of funding for PSAPs, less than 3,000 of the 6,000 PSAPs support “Text-to-9-1-1” technology. This means if you use your mobile phone and text 911 information about an emergency, it will work less than half the time. Also, “Text-to-9-1-1” usually does not provide the needed information for a 911 dispatcher to deploy the correct resources. So, even if the message goes through, you will need to follow up with a phone call which will often be to a different dispatcher than the one who received the text.
When it comes to telemedicine, the infrastructure has even more problems. Today, most telemedicine visits are done by mobile phone or computer video conference. Not only is the location unreliable, the caller is not the patient, and the patient can be in any city or state. Remember, the PSAP coordinating response needs to be in the same jurisdiction as the patient to coordinate a response with EMS. So, the doctor needs to talk to that specific PSAP dispatcher. When a doctor calls 911, even from a land line, the doctor reaches the PSAP corresponding the doctors address and the doctor’s billing address comes up. The PSAP dispatcher is in the wrong area. The further away the patient is from the doctor, the harder it is to locate the right PSAP.
Why did this happen? Over the last many decades there have been a lack of upgrades to the 911 infrastructure itself. If you look at a phone bill from the United States, you should see a 911 tax added. However, much of 911 tax has been reappropriated to other needs of government leaving PSAPs starved of funding. Proposals have been made to congress for a new next generation system which will take a decade to build and cost over one billion dollars. We are still far from building a new 911 infrastructure. Today, some PSAPs have the funds and have upgraded to newer broadband based next generation systems but many are still using the same systems. The core infrastructure, however, is still the same.
Telemedicine911 was built as a reliable accurate way for doctors and healthcare professionals to both call and text 911 for PSAPs in the United States, whether traditional or next generation. We have not found any PSAP in the United States which does not accept the “Telemedicine 911-
What are the appropriate use requirements of Telemedicine911 and how do they align with Joint Commission Guidelines?
Telemedicine911 is designed as a tool to hand-off patient care from a remote provider to the 911 infrastructure.
Appropriate Use Requirements of Telemedicine 911
- Use the standardized text and verbal communication for the critical content including patient name, response type needed, facility needed, and call back information at a minimum. Communicate additional critical information with 911 and downstream responders including Illness assessment, severity, patient summary, action list, contingency plans, allergies, code status, medications, test results, and vital signs.
- The provider managing the patient needs to verbally discuss critical information and needs with the 911 dispatcher and provide an opportunity for dispatchers and downstream responders to ask questions.
- Include the direct call back number of the provider managing the patient for 911 dispatchers and downstream responders to ask questions.
- Users and client organizations must have a systemic approach to safety in addition to the use of telemedicine911 including validated contingency protocols, staff training for emergency identification and procedures, and review oversight procedures.
- Users must accurately represent credentials and patient information with 911 personnel and downstream responders.
- When testing, users must follow testing scripts, effectively communicate that the activation is a test, and prepare a location address site for responders to arrive regardless if the 911 activation is a test.
- Users must follow all state and federal laws, regulations, and guidelines.
- Users must treat all 911 personnel with respect and communicate in a professional manner.
The software and its appropriate use has been developed from the Joint Commission guidelines for Hand-off communication, Sentinel Adverse Event underlying causes, and I-Pass methods.
In 2006 the Joint Commission established a National Patient Safety Goal that addressed hand-off communication. In 2010, the requirement became a standard PC.02.02.01 element of performance (EP) 2. Telemedicine911 aligns with these goals as a central tool to implement patient safety and high quality hand-off of patient care. For behavioral health care, this requirement is Care, Treatment, and Services standard CTS.04.01.01, EP 3. Organizations should also reference Provision of Care, Treatment, and Services standard PC.02.02.01 for ambulatory care settings and hospitals.
Gaps in communication during hand-off processes increases patient safety risk. Inadequate handoff communication causes adverse events including delays in treatment and error in all medical areas including practices, hospitals, and telemedicine. A study released in 2016 estimated that communication failures were responsible in part for 30% of all malpractice claims, 1,744 deaths, and $1.7 billion in costs.
What are the Local EMS, Police, State, and Federal rules and guidelines around 911 and telemedicine?
Any information provided is not intended to be legal or medical advice, but rather act as inspiration for our users to develop optimal policies and procedures around the use of Telemedicine911.
Testing and False Calls to 911
Telemedicine911 encourages testing of your emergency protocol and systems. Please contact your local PSAPs to test your systems.
Suicidal and Homicidal patients who do not want 911 activated
Suicide is the 10th leading cause of death in the United States. If you have not encountered a suicidal or psychiatric behavior patient over telemedicine over the phone/video, you likely will as you continue remote care of patients.
When patients say “I want to kill myself” while on the line, the majority of the time the patient will refuse 911 activation. At a minimum, we recommend;
- Providers must assess whether the comment was true to the intentions of the patient or not. Given suicide is a top cause of death, we recommend erring on the side of safety. Additional factors to consider include psychiatric history, non-complience with psych medications, a suicide plan, access to firearms and medications, previouos suicide attempts, and other risk factors.
- Providers must assess the capacity of the patient to make sound decisions in refusing 911 activation. If the patient lacks capacity, you may need to activate 911 for the patient regardless of consent. For more information on how to assess capacity and competence, please subscribe to our patient case newsletter for our case series.
- Ask the patient about their “plan.” There is strong medical evidence that asking the patient “how do you plan to do it?” does not increase the likelihood the patient will complete the plan. However, knowing the plan will help with your 911 activation. Access to firearms or guns is associated with higher rates of completing suicide and poses a threat to first responders which you need to tell 911. Access to medications increases the chances of overdose and responders need to find the pill bottles and bring them to the ER. We have had cases where patients said they would jump on train tracks and EMS and police met the patient en route. Police and EMS knew to leave the empty apartment and go to the train only because we told them during the 911 activation call. Provide responders as much information about the plan and the situation so responders may provide the highest quality response.
- Deliver a complete and succinct handoff. Each locality and state will have different procedures for who is the best person on 911’s end to receive the handoff information. Do not be surprised if 911 dispatchers conference in or patch you into ambulance dispatchers and paramedics directly for optimal handoff. We advise speaking directly with the paramedic and providing the direct callback number of the doctor or provider managing the case. If you are not speaking with onsite responders, you may request to do so. However, please understand many PSAPs may not have the technology for these types of conferences. In this case, request onsite responders to reach providers on the callback number provided.
- When using Telemedicine 911, activate both Police and EMS to respond to suicidal involuntary consent patients. Police are trained to handle involuntary patients both physically and legally. Suicide centers accross the United States usually activate police as well.
Stopping 911 Activation and Response when situations change
- Stopping 911 responses happens all the time. Situations change. Patients improve and no longer have an emergency or the patient who has the capacity to make decisions and they change their mind and do not want to go to the hospital. The procedure to stop is generally the same in most localities. When ambulances arrive, they usually have the patient or guardian sign a Refusal of Medical Care form (RMA) which is similar to a hospital Against Medical Advice form (AMA). An example form is provided below.
Although any medical provider can call 911, we advise providers to talk to the patient and have them agree to the medical plan. There are times when consent is implied. When patients are unable to speak, is unconcious, or lack capacity or competency, medical persons can generally deliver care under implied consent.
Persons under the age of 18 need the consent of a parent or guardian for medical decisions. In some states pediatric patients may consent for themselves if emancipated due to marriage or having children. In cases where a pediatric patient has a risk to their life or limb and parents or guardians are refusing 911 activation, you must activate police and child services along with EMS in order to override these decisions. Officials will need to take protective custody of the child to consent for medical treatment. In most cases, good handoff and discussion with 911 regarding the situation will yield the best outcomes.
Why is text information important for handoff to 911 and EMS?
Text information greatly helps in communicating essential information to the 911 dispatcher and EMS. A study by Bhaba showed that after five handover cycles, only 2.5% of patient information was retained using the verbal-only handover method, 85.5% was retained when using the using the verbal with note taking method and 99% was retained when a printed handout containing all patient information was used.(1)
The Joint Commission in their Sentinel Handoff Guideline also recommends both verbal and text information in handoff procedures.(2) Telemedicine911 allows medical professionals to pass along text information to improve communication to 911 and downstream emergency providers. achieves the best communication so Telemedicine911 is designed to deliver both text information and a phone call to the same 911 dispatcher at the same time.
Standardization in handoff structure and content has been studied extensively. In the IPASS framework study, verbal and written handoff of critical information has shown to reduce medical error by 23% and reduce preventable adverse events by over 30%.(3)
Telemedicine911 uses both standardized and flexible communications standards for both electronic textual handoff information and verbal communication which is specific to telemedicine and remote care. Telemedicine 911 Critical Standardized Text and Script provided in the software includes;
- Patient Name and Verified Location
- Type of Response Needed
- Facility Needed
- Free Text
The patient’s name is critical text to be sent in a remote care to 911 handoff scenario. The spelling of a patient name sent over Telemedicine911 text is forwarded by 911 to first responders to help identify the patient onsite. The name then gets entered into the EMS prehospital care report and is used to identify medical records at the hospital. Hospital doctors use this information to pull previous medical records, allergies, and other information pertinent to the immediate emergency care of the patient. Barriers such as accents, language differences, audio skips, and other verbal problems on a 911 phone call can reduce the communication between the medical professional and the 911 dispatcher. It is much more reliable for you to verify the name 911 dispatchers see on their screen in addition to verbally spelling it to reduce inherent error and delay. Too often do patients arrive at an emergency department without identification cards or accurate name information when they have altered mental status or language problems preventing them from articulating their identity. One letter off could mean the difference between the correct identity and not. Lack of identification and medical records in the emergency department has led to delays in definitive treatment and poor outcomes. In the United States emergency department bad outcomes due to lack of identification or wrong identification happen more often than you think. If your case is at higher risk for mistaken patient identity for downstream providers, you can use Telemedicine911 manual edit text to include both the patient name and date of birth for better identification.
The “type of response needed” standardized content helps convey information on the illness severity and actions needed for the patient. This standard supports telemedicine and remote care emergency unique handoffs across differing health professionals including physicians, nurses, EMTs, dispatchers, and police. For example “ALS” text communicates both a high severity illness and an action plan which can be further clarified verbally on the call. ALS and BLS also convey response needed information in very few characters which help United States PSAPs which have display restrictions.
The “facility needed” can be clicked or custom. Shortened terms are more reliably displayed on text. In all cases, confirm the facility verbally and the reason for the type of facility. While en route EMS may change destination based on the patient’s changing condition, traffic conditions, or other reasons.
The textual electronic template may be used, ignored for free text, or augmented by the user to match the needs of the situation or your organization.
Telemedicine911 text should not be confused with the US “text-to-9-1-1” program started in 2014. The “text-to-9-1-1” program is for the general public to contact 911 with texting devices such as mobile phones and is currently available in less than 3,000 of the 6,000 or so 911 dispatch centers. We have never found a United States 911 dispatch center (PSAP) that does not accept and display text from Telemedicine911 software.
When should I select BLS transport and response?
The response of ALS can often be glorified by a paramedic racing down the highway at 100 mph, putting a tube down a heart attack patient’s throat while in the back of the ambulance, siruns running, with the stench of smoke on their jacket from the burning building they just left. While this does happen from time to time, this is very rare.
In reality, the everyday life of 911 is mostly BLS response and transport. BLS happens over 90% of the time with traditional 911. And, for Telemedicine video visits, it’s about the same. 9 times out of 10 activations will need only BLS. One exception to this rule is remote cardiac monitoring emergencies, where arrhythmia emergencies almost always need an ALS response with cardiac meds and an ECG at the ready.
When activating 911 through the Telemedicine911 software, you can recommend Advanced Life Support (ALS) ambulances with paramedics or Basic Life Support (BLS) ambulances with EMT-Bs. Telemedicine911 allows you to both send the information via text and verbally recommend the level of care with the 911 dispatcher over the phone. The key is to never make recommendations above your level of training and education and only aid the 911 dispatcher in making the choice. 911 dispatchers are trained to determine what type of response is needed, however they may not have the same detailed information about the patient which you do. The information you know and communicate about the patient and situation can make a big difference in the level of care the patient receives.
911 ambulance dispatchers are often EMT-Bs, the same EMTs on BLS units. They are trained in a set number of scenarios such as trauma, chest pain, bleeding, and other common complaints. They are trained to ask only two to four questions in determining whether BLS or ALS is needed. You have spent much more time with the patient and likely have a different type of education to determine the risk of the situation. It is often best for you to choose one of three actions; not activate 911, activate and choose BLS, or activate and choose ALS.
Choosing between ALS and BLS is usually an easy choice with less stakes. Paramedics on ALS ambulances have medications and devices to manage critical patients. BLS ambulances only have medications limited to charcoal and oxygen most of the time. Ambulances communicate with each other, can upgrade response if needed, and are both usually within an 8 minute drive of a hospital in most urban and suburban areas. The choice for ALS often involves obvious symptoms such as crushing chest pain, suicidal ideation with a plan, unilateral weakness indicating a stroke, altered mental status, arrhythmia on remote monitoring, and other obvious symptoms. If you have a hard time determining whether ALS or BLS is needed, you should let the 911 dispatcher decide and leave that text section blank.
What if the patient does not know their location? What is GeoPhotoLocate™?
It is important to understand 911 infrastructure problems when it comes to location and cellular services. Most regular 911 calls by patients are through mobile phones unveiling a critical flaw in the 911 system. When a patient calls 911 on their mobile phone, the call is based on the location of their cell phone tower which could be miles away or in another city. This often results in the wrong dispatcher being contacted and the ambulance not going to the correct location. Standard mobile apps for ordering car taxis or pizza delivery have better technology and are more accurate than 911 mobile calls. By 2021 the FCC is requiring mobile phone carriers to be only 80% accurate for mobile 911 calls, today they are only required to be 40% accurate which is scary. Telemedicine911.com uses grounded address entry and advanced geolocation technology to pinpoint the location of your patients with far more accuracy than if the patient called 911 with their own cell phone.
Standard mobile GPS for pizza delivery or car service is superior to 911 mobile location most of the time, but it’s still not good enough for emergency response. If the mobile phone location is off by 50 yards, an ambulance will go to an address 50 yards away which could be just down the street, around the corner, or on a different floor. Most ambulance protocols for mobile 911 calls have paramedics and EMTs search for the patient for 15 minutes, then they leave and close the job. In the United States, an ambulance searches for mobile 911 callers, can’t find them, and leaves an estimated once every minute. It happens a lot.
For Telemedicine the problem is compounded. Over 80% of telemedicine is done via patients’ mobile phones and this means they can be located anywhere. Fortunately, most of the time the patient is at home or work where they know their address. The rest of the time patients do not know the exact address of where they are. They may be able to describe a store or street name but they don’t know the exact location.
Telemedicine911’s GeoPhotoLocate™module helps find the location of the patient. It is best used with a live patient on video conference or audio connection. The system starts by using the mobile phone locator to cross reference historical pictures where the patient is. Through video conference and patient conversation providers can identify landmarks, streets, stores, or other items from a database of pictures in the patient’s general location.
Here is an example scenario. Your patient is on a telemedicine video visit with you and has severe right lower abdominal pain and you would like the patient to go to the emergency department. She is in a mall. You GPS ping her mobile phone and the location pin drops in the center of the mall. Paramedics would take longer than 15 minutes to find her with the general address of the mall. GeoPhotoLocate on the Telemedicine911 platform displays a series of historical pictures from the patient’s general location, a picture of a Starbucks coffee shop and a green statue. You look in the background of the video to see if there is a matching picture or you ask the patient “do you see the green statue.” You ask, “do you see the Starbucks coffee?” The patient says she sees the green statue and you ask her to stay there while you activate 911. The latitude, longitude, and address is sent to the Telemedicine911 address validation page. You add the manual Telemedicine911 text, “South Entrance next to green statue.” Detailed location and description text is sent to 911 while on the call and forwarded to paramedics. Paramedics find the patient within minutes.
GeoPhotoLocate™ uses the latest combination of location technology so you have the best chance of relaying the most accurate location. At times, GeoPhotoLocate™ mobile GPS location will be enough. When it’s not enough, photo location matching gets the paramedics where they need to be. Contact us if you would like to add GeoPhotoLocate™to your plan.
What is the drawback in also creating a centralized 911 relay center, transfer solution, a 911 PSAP call center contact database, or ambulance company database?
911 was not built for Telemedicine and actually has additional problems with even handling normal 911 mobile calls. Of the 6,000 or so 911 PSAPs in the United States, some have better infrastructure and can handle special methods. Many PSAPs are older, not well funded, and lack the infrastructure to handle these methods. Below are some of the experiences from medical professionals testing these methods;
Central relay centers work by having a dedicated agent coordinate 911 or emergency responders. Providers with an emergency call, and they call the local municipalities, ambulance companies, or 911 center. An experienced agent can ease the stress from a provider who rarely has emergency situations. Telemedicine911’s ultimate plan is designed for the central call agent who manages a large number of emergency calls. Your providers can call the central line and your agent equipped with Telemedicine911 ultimate can activate 911 for them. However, there is added risk in introducing an intermediary to the 911 call process. If the central agent is busy or unavailable, the 911 call cannot be made. This also introduces another set of points of failure in the process. Using Telemedicine911 for a central agent is a method to reduce Telemedicine911 costs since you may not need as many users, but we feel direct activation by the provider recognizing the emergency is always best. Please see Telemedicine return on investment section as we feel the platform more than pays for itself.
Most 911 dispatchers have the ability to transfer calls to other PSAPs but it is not in the way you think. They transfer based on the presumed city or county, not the address most of the time. This results in the PSAP often transferring your call to wrong PSAP when there are multiple PSAPs servicing a county. Telemedicine911 performed a study and found that transfers were correct about 62% of the time. When the target PSAP was further away or in another state, the error rate worsened. You end up getting bounced from PSAP to PSAP checking each time if they service the location of where your patient is until you find the right one or your call is dropped. Clients of Telemedicine911 have also had cases where the PSAP would not transfer the calls after repeat requests. Other clients still have complained that when using a mobile phone to call 911, transfers sometimes didn’t work at all. However, some hospitals have onsite next generation PSAPs who can coordinate much more accurate routing but they still lack the patient text information in the 911 calls. 911 calls should be reliable, without middle agents’ delays, and needs to include patient name and other information. Even these secondary backup methods need to be tested.
PSAP contact databases are often just lists of 911 supervisor phone numbers, not direct lines into dispatch stations. This means there could be twenty 911 dispatchers available, but if the supervisor is not available, or is on another line, your emergency call might not go through. As Telemedicine increases, overuse of PSAP database phone numbers will further exacerbate the problem. There are further problems of corresponding the patient location with correct PSAP, no patient name text, and out of date lists which change monthly. This is our experience. We have done this method and experienced the problems, so you don’t have to.
Ambulance company databases usually fail due to time of response and inconsistency. Databases usually contain ambulance companies both assigned to 911 at that time and those not assigned. 911 works with ambulance companies assigned to a geographic zone and have ambulances stationed within minutes of every location in that zone. This provides the national 8 minute response time for 911 emergencies. As emergency jobs are taken by ambulances, the director tracks which ambulances are available and their location so they may provide adequate coverage over the geographic zone. The ambulance companies’ coverage can change on the hour depending on the number of emergency jobs. Medical professionals searching for ambulances in a database or on the internet sometimes may get lucky and find the exact ambulance company who has a rig close to the patient and not on another job. And, sometimes they reach an ambulance company who does not, but will still agree to pick up the patient. In many cases, the ambulance does show up, but hours later. If you have any experience scheduling ambulance transportation at a hospital, you may understand the delays that can happen, it’s hit or miss. 911 maintains coverage and is better than accidentally coordinating with the wrong ambulance.
These methods are less reliable and slower than Telemedicine911. You should, however, take them into consideration as a backup plan in your emergency response protocol.
How do I calculate the ROI of buying Telemedicine911 and my competitive benefit?
Telemedicine in the United States is fiercely competitive. Providers and companies a thousand miles away have increased their telemedicine usage and can easily compete for your patients at lower cost than you. Times are getting more tough and you need to justify everything you buy while improving your business. Below are some of the top ways clients identify and calculate the Return On Investment (ROI) and competitive benefits when buying the Telemedicine911 platform.
Telemedicince911 improves patient retention by delivering quality comprehensive care. Patients don’t usually like to be hung up on and told to call 911. Emergency coordination is part of comprehensive care. When you command the local healthcare resources, you are delivering more competent care. If you use Telemedicine911 on the same device as your video or audio consult, the patient will hear you when you talk to 911. We find that patients are comforted when you command ALS, BLS, and facilities needed. Patients feel that you are taking care of them. We also find that use of Telemedicine 911 creates more immediate follow up visits, improved satisfaction with your telemedicine, and more future patient outreach to you. We find that one Telemedicine911 activation vs usual care results in 1.9 additional patient encounters in the next week, and years of improved patient retention. Calculate the ROI with the revenue from increased immediate patient encounters and encounters from long term retention of patients.
Telemedicine911 improves continuity of care to your facilities. When patients call 911, the ambulance can take them to any hospital where they may not have medical records. Telemedicine911 texting of the facility name of where the patient’s medical records are will improve continuity of care, reduce medical error, and result in better clinical outcomes. Telemedicine911 will help continue the care in your own facilities. Continuity of care is a large clinical benefit which will give you a competitive advantage.
Expand your clinical market size. Telemedicine911 expands the types of patients you can see over telemedicine. Doctors practicing traditional telemedicine without emergency response usually saw patients for medication refills and prescriptions, coughs, and colds. Talk to your medical director about the types of patients you may be able to see with a more reliable 8-12 minute emergency ambulance response. Can you expand your telemedicine to chronic care patients who have a higher likelihood of emergencies? Can your medical director identify facility patient costs which could be replaced by your cheaper telemedicine program now enhanced by Telemedicine911? Calculate the ROI using the revenue of new types of patients or savings from facility cost reductions.
Telemedicine911 actually enhances your services, and you should add this to your marketing. Build ads emphasizing your connection to onsite immediate health delivery infrastructures. Telemedicine911 allows you to command a connection to ambulances and facilities, onsite where patients are. This is a much different telemedicine offering and builds a better product for you. New ads can resonate ideas such as “Care Anywhere is just the start, we are connected to your local emergency services and facilities. If needed, we can have a paramedic physical exam in an average of 8 minutes. Care anywhere, also connected to emergency medical in-person care where you are.” You also may just find that you uniquely reach patients who don’t like telemedicine due to lack of a physical exam but like the in-person emergency attributes of your telemedicine offering. Your new enhanced service ads may reach these patients and open up additional care. Calculate the ROI with the revenue from this new patient segment added to your telemedicine program or by evaluating AB tests against your usual marketing.
Expand and retain your workforce. Recruiting doctors and providers is hard but you can use Telemedicine911 as a recruiting tool. Advertise to your job candidates you have a reliable platform to activate 911 wherever your patients are located. Your competitors may have a hard time showing they have a reliable method, and further point out methods like ambulance lists which are not reliable. It may just be the tipping point for candidates to choose you. But, retaining your staff to continue to do telemedicine is also tough, it is after all their medical license on the line. Telemedicine is not part of standardized medical school or residency curriculum, even now. New and seasoned doctors alike were not trained for video exams or other telemedicine. You can still teach providers to ensure good outcomes. But you can’t teach good infrastructure. It just takes one delayed incident to unveil your infrastructure problem. And it just takes one infrastructure failure gap to alarm a large portion of your staff against practicing telemedicine. Calculate the ROI with the probability of a bad incident multiplied by all the revenue produced by the estimated loss in providers. Or, calculate the ROI by the savings from ease of new recruitment.
Lastly, you can reach out to your malpractice or liability carrier for rate reductions. Telemedicine911 increases the reliability that emergency situations are handled for your patients. It also may transfer some of the medical liability and responsibility to the ambulance company and downstream facilities. Carriers vary, but they do usually appreciate when you reduce their liability and financial risk. Calculate the ROI by the reduction in your premium.
Do I need to be a medical professional to use Telemedicine911?
911 is a public service in the United States where anyone can use the 911 service. Although any age person may call 911, we ask only persons age 18 or above in the United States may purchase or use Telemedicine911.com software. We do ask our medical professional users to include their credentials when creating a user account so we may add more credibility to your 911 Activations for special participation dispatches.
Although Telemedicine911 is primarily designed for medical emergencies, it can also be used for emergencies threatening people or property. Police emergencies such as robberies and domestic violence as well as fire emergencies use the same 911 dispatchers.
911 dispatch centers track 911 calls and Telemedicine911 911 Activations back to the users who activated 911. Just like when placing a call to 911, use Telemedicine911 responsibly for situations for which you feel there is an emergency.
Please use 911 responsibly.
How do I purchase and set up my account?
- Telemedicine911 Terms and Conditions
- Telemedicine911 Business Associate Agreement (BAA)
- Telemedicine911 and Air Visits Privacy Agreement
Enter your credit card or bank information for recurring payments and you will be charged for the first month of services. Each month you will be charged for the next month of service and for the previous month’s overages in 911 activations. All users under each account are under the same level plan, standard, premium, or ultimate. Users pool the allotted 911 Activations over the month which expire at the end of the month. For example if an account has two users and one user completes double the 911 Activation allotment and the other user completes none, the account will not have any overages. If your account needs some additional 911 Activations, simply buy more users to increase the account pool of allotted 911 activations. However, at about double the users it makes more sense to upgrade your account to the next level plan. To have users on different level plans you simply need to create an account for each level plan you wish to have. 911 Activations are not shared or pooled between different accounts.
Users may have different level permissions in the account. There are no pure administrative accounts, all users can activate 911.
If you are ever dissatisfied with Telemedicine911, please talk to our call agent. We are interested in knowing why you are dissatisfied. The call agent has the authority to issue a full refund for the services.
Conversely, if you like the platform or have some recommendations of what you would like to see, we would be interested in having a call with you. After the conversation, call agents can add additional activations to your account free of charge.
Can I test my Telemedicine911 account?
We encourage testing of all medical protocols. Here at Telemedicine911.com, we extensively test 911 activations throughout the United States and we have yet to find any dispatches that do does not work with our platform. It is illegal to make false calls to 911. If you would also like to run your own testing, please contact your state and local 911 authorities to set up testing. It is important to tell 911 dispatchers your call is a test immediately. Also, test using known addresses with people on site who are expecting police or ambulances to show up since many ordinances have policies to send police or other units to addresses regardless if it is a test or not.
We also encourage testing of contingency protocols for emergencies. Telemedicine 911 is an internet based software, so when the internet has trouble, power is down, or your smartphone’s battery dies, it will not work. Practice logging in to your account on the computer and mobile phone so you have two means to reach the platform on different internet channels and power sources. Set up emergency outreach with alternatives to using Telemedicine 911. Document your emergency protocols and contingencies in your standard operating procedures and educate staff on its use.
Is Telemedicine911 all I need for my emergency plan?
Telemedicine 911 should be one part of your emergency plan. Although the uptime of Telemedicine911 is greater than 99.9%, you should plan for some of the top reasons emergency coordination fails.
The most common reasons emergency activation have been delayed are; the there is an internet outage, the wireless headset is out of power, the backup mobile device has limited signal, there was no test of the system after installing new audio/video devices or software to your computer, you are attempting to log in and test for the first time at the time of an emergency, and your login information is not readily available. We have seen these problems often and you should plan for them.
Telemedicine 911 is a web based application so changes to your Chrome, Microsoft Edge, or Firefox browsers or changes to your operating system may require testing the Telemedicine911 again but we have yet to see problems with updates.
Are there any resources for PSAPs, EMS, Law Enforcement, and special agencies?
Yes, we have training documents and guidecards available to 911 dispatch, Public Safety Access Points (PSAPs), and Emergency Medical Services which are updated periodically. There is also special software access and integrations for higher level communications and reporting. There are also access and software available for Special Agencies and Law Enforcement.
Select PSAPs and states can work directly with telemedicine911. PSAPs can create protocols to read credentials on our codec. This would help dispatchers and ambulances to know credentials of the telemedicine911 user activating 911. If you would like to request for your state or PSAPs in your area to work with Telemedicine911 and your credentials to appear on the codec, please contact us at firstname.lastname@example.org. 911 dispatches without Telemedicine911 protocols should still receive information from the software.
Please contact us for more information.