Efficiency was a good word to use for new implementation at Butler County health services, Frank Williams said.

At its Tuesday meeting, the Butler County Commission approved an agreement to implement a new telehealth system, MD Ally, as part of servicing 911 non-emergent injuries and illnesses within the county. It is a one-year contract with potential for a two-year renewal, according to documents released by the county.

As 911 call volume continues to rise and physical transports continue to fall, moving towards a more modern approach to treating those with non-emergent ailments is set to help in a number of areas, Williams, Butler County EMS director, said.

“I am home-grown here, this is where I live and breath and this is where my family is from,” he said. “The Midwest in general, rural frontier communities, typically get left behind in these situations. I am so happy there is a larger picture out there because it is needed most in the rural frontier communities.”

MD Ally has its own healthcare professionals, Williams explained, that will help assess patients over the phone who call in and may have a non-emergent ailment. Williams stressed that this will not hinder responses to serious emergencies.

“[MD Ally’s’] job from there will be to link those callers back into local care, meaning that after they’ve had this discussion and done an assessment over the phone, we will stay on the line at the 911 center and monitor that in case something changes and we need to send an ambulance. Other than that, if it is still non-emergent, they will link them back to a local primary care physician or urgent care maybe that is more appropriate for that kind of care.

“When it is true emergency like a care accident, fall from a high place, heart attack, stroke, all of those different categories, they are going to be treated completely different. They aren’t even going to be considered from the very start of the questioning. I think that was our attempt to separate that so people really understand 911 calls that are true emergencies will no be delayed.”

Williams, along with Chris Davis, 911 director, and Dr. Paige Dodson, medical director, created a Q&A YouTube video to help answer public questions about the service at bit.ly/2R283P2

Williams also encouraged anyone with questions to reach out. The service is expected to kick off within the next 60 days, he said.

Five Years in the Making

The conversation to find a way to help with the rising number of non-emergent 911 calls began about five years ago, long before Williams began his position in March, he said.

“This is a pilot program,” Williams said. “We first looked at CMS, the Medicare provider for the national program. They started a grant program and we were really hoping we would qualify for that grant because it is the same type of teleheath, telemedicine opportunities for EMS. Unfortunately we are not big enough because we a rural frontier community to even have enough Medicare patients to transport to qualify. So, we reached out through national conferences and we weren’t able to find anybody that could do this other than MD Ally. That is why this is a pilot program for them, to prove that this works. That is how this relationship came about.”

The stress on rural healthcare to meet community needs was one of the largest factors. The decrease in resources, along with continuously rising costs are factors that played into collaboration between hospitals, physicians, nurses and EMS to find more efficient avenues, he added.

“A lot of people think that non-emergency illnesses or injuries don’t get called in to 911, but 25 percent of the time, at least in our county, that does happen,” Williams said.

Cost was also a factor as the need for more resources climb.

“So, we have a choice,” he said. “We can either add more resources as far as ambulances and crew members to the cadre of taxpayer provided services, which is a pretty large expense...compared to other alternates.”

While there is potential to renew contractual services with MD Ally, Williams added there may be even more modern telehealth services that could be implemented in Butler County for future use.

“A year seems like enough time for us to learn a lot about anything that would be more beneficial for the community,” Williams said. “MD Ally also has actual remote telemedicine capability that they are also testing with other EMS programs, so that maybe something that we are able to enhance where we have a paramedic or an EMT on scene with telemedicine being able to remote in with a physician in some cases. I think it will grow from here. We are being pretty conservative and we want to make sure we are pretty safe with the program to start with. In that year, I think we will learn a lot and see a lot more opportunity.”