Initiative Gives Rural EMS Responders 24-hour Access to Emergency Medicine Physicians

February 1, 2021

Watch the feature story by Arizona Public Media.

TUCSON, Ariz. — Advanced telehealth technology is being used to improve patient care in the field by connecting rural emergency medical services (EMS) responders to Tucson emergency medicine physicians in a joint project involving the University of Arizona Health Sciences and Banner – University Medical Center Tucson.

AzREADI, a new initiative involving the University of Arizona Health Sciences and Banner – University Medical Center Tucson, utilizes a telehealth platform that gives EMS providers at the scene of an accident access to emergency department physicians to virtually receive input on the best treatment option for a patient. (Photo: University of Arizona Health Sciences/Kris Hanning)Rural EMS and ambulance agencies face several challenges in providing sustainable prehospital care to remote communities, including low call volumes, long transport distances, reliance on volunteers, an aging workforce and difficulty meeting increased educational standards. The Arizona Rural EMS Advanced Telemedicine Demonstration Initiative (AzREADI) addresses these challenges by giving rural EMS responders 24/7 access to real-time consultations with board-certified EMS physicians.

“Connecting to a remote specialist prior to hospital arrival can decrease the time from symptom onset to treatment, which is especially important for stroke or traumatic brain injury, for instance, when ‘time is brain,’” said Joshua Gaither, MD, associate professor and EMS Fellowship director in the UArizona College of Medicine – Tucson’s Department of Emergency Medicine.

The use of telemedicine services is vital in rural areas, where the COVID-19 pandemic has stressed already limited resources. AzREADI capitalizes on improvements in wireless broadband capabilities to extend communications and improve real-time patient care while optimizing resources and decreasing costs.

AzREADI will allow emergency department physicians in Tucson to make a diagnosis, recommend a transfer or prepare the medical equipment necessary to treat the patient upon arrival, all via a dedicated telehealth platform. (Photo: University of Arizona Health Sciences/Kris Hanning)

“EMS vehicles are being equipped with broadband cellular connection and high-speed internet access to the Banner – University Medical Center Tucson Emergency Department, making it much easier for an emergency department physician to immediately access the information, make a diagnosis, recommend a transfer or prepare the medical equipment necessary to treat the patient upon arrival,” Dr. Gaither said.

Two partner EMS agencies are participating in the pilot program: the Rio Rico Fire and Medical District, serving the rural area just north of the Arizona-Mexico border; and the Sonoita-Elgin Fire District, serving rural communities between Tucson and Sierra Vista. Cobmined, their EMS service areas include 19,941 Arizona citizens and span 792 square miles in southern Arizona.

“Having the AzREADI resource available to the crews gives them a very near ‘in-person’ medical support experience,” said Richard Johnson, deputy chief of the Rio Rico Medical and Fire District. “The ability for them to contact a physician and, via the technology, hear the medical recommendation is a great comfort to me as a supervisor, knowing that my personnel are supported to that extent regardless of their location.”

EMS vehicles are being equipped with broadband cellular connections and high-speed internet access, which provides EMS staff with real-time medical support. (Photo: University of Arizona Health Sciences/Kris Hanning)"With the technology resources provided by AzREADI, we now have the ability to share vital clinical information with doctors in real time, which makes for more effective decision making and ensures that patients get the best care while allowing us to maximize our resources,” added Marc Meredith, acting operations chief of the Sonoita-Elgin Fire District. “We are grateful to be part of this important program to enhance medical care in rural settings.”

AzREADI  is funded by a Health Resources and Services Administration (HRSA) grant with the UArizona Center for Rural Health at the Mel and Enid Zuckerman College of Public Health. The Center for Rural Health was one of only eight recipients in the nation to receive a three-year, $750,000 supplement to its HRSA Rural Hospital Flexibility Program award for the AzREADI project. 

Joshua Gaither, MD, is an associate professor and EMS Fellowship director in the Department of Emergency Medicine. (Photo: University of Arizona Health Sciences/Kris Hanning)

“EMS providers can use the AzREADI telehealth platform at the scene of the accident or illness or en route to a medical facility to virtually receive additional input on the best treatment option for the patient,” said co-investigator Amber Rice, MD, an assistant professor in the Department of Emergency Medicine who also serves as medical director for two Tucson fire departments. “The anticipated effects are better triaging, advanced onsite care, and referrals to facilities that could best meet the patient’s needs.”

Other co-investigators are: Melody Glenn, MD, assistant professor and base hospital medical director for Banner – UMC Tucson, and Daniel Spaite, MD, professor and Virginia Piper Distinguished Chair of Emergency Medicine, from the Department of Emergency Medicine; and Arizona Telemedicine Program Founding Director Ronald Weinstein, MD.

“We are thrilled to partner with these outstanding agencies, using technology to help connect patients and providers to more resources,” Dr. Glenn said. “This innovative project allows us to achieve one of the main goals of high-quality prehospital care: get the right care to the right patient at the right time.”

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NOTE: Photos available: https://arizona.box.com/s/ncv18broidh3a323i8ky8pj9c8s5pgs5

About the University of Arizona College of Medicine – Tucson
The University of Arizona College of Medicine – Tucson is shaping the future of medicine through state-of-the-art medical education programs, groundbreaking research and advancements in patient care in Arizona and beyond. Founded in 1967, the college boasts more than 50 years of innovation, ranking among the top medical schools in the nation for research and primary care. Through the university's partnership with Banner Health, one of the largest nonprofit health care systems in the country, the college is leading the way in academic medicine. For more information, visit medicine.arizona.edu (Follow us: Facebook | Twitter | Instagram | LinkedIn).

About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. UArizona Health Sciences includes the Colleges of Medicine (Tucson and Phoenix), Nursing, Pharmacy, and the Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, Health Sciences reaches across the state of Arizona, the greater Southwest and around the world to provide next-generation education, research and outreach. A major economic engine, Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners $200 million in research grants and contracts annually. For more information: uahs.arizona.edu (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram).