By Jayme Lozano Carver, The Texas Tribune
LUBBOCK — West Texas is home to endless miles of plains filled with oil field machinery, wind turbines, farms and ranches.
But what’s not always available in the deep stretches of empty plains and state highways are hospitals and emergency rooms — leaving the people who live there or traveling without immediate care in their time of incredible need.
A pilot program at Texas Tech University Health Sciences Center has the potential to solve many of those concerns facing rural health care in West Texas. And the program is getting a boost from the Texas Legislature.
The program — established by House Bill 617, spearheaded by Republican state Rep. Drew Darby of San Angelo — provides emergency telemedicine medical services and telehealth services in rural areas by installing secure video calls and wireless patient monitoring in ambulances already in transit to an emergency room.
This allows a physician participating in the program to review the patient’s condition and symptoms remotely, then make a recommendation on how the ambulance crew can treat them until they get to the nearest treatment facility.
Advocates for the program are hopeful it will close the gaps for people who travel or live in the far-flung corners of Texas, and have to drive a considerable distance if they are sick, injured or dying. Dr. Billy Philips, executive vice president for rural and community health at the university, said EMS services statewide are having issues getting patients the right care in a timely manner.
“We want to better serve the millions of people that live out here,” Philips said. “They can begin the care process as they move the patient, and that leads to less duplication of services and better outcomes.”
The legislature is investing in a program that has already shown results — Texas lawmakers approved the start of the program in 2015, but the funding fell through in a later session. During the first trial run of the program, they focused on the Trans-Pecos region in far West Texas because it is a major transportation zone and has oil and gas production.
“When we started this endeavor, it was really geared for a problem we see a lot in our rural areas, particularly with all the oil and gas activity, catastrophic wreck and injuries,” said James Beauchamp, chair for the Commission on State Emergency Communications.
The first hour of care — often referred to as the Golden Hour — is critical, Beauchamp said. The sooner a patient is treated, the more likely they will survive.
According to Beauchamp, the first iteration of the program showed they can reduce fatalities or deaths by a third.
“Anything you can do to reduce fatalities or deaths by that much is pretty significant,” Beauchamp said.
When the program first started, however, Beauchamp was surprised to see some EMS providers hesitant to join. He later found out it was because most of them had protocols in place from the 1960s, so the providers didn’t know if they were allowed to do the program, and they didn’t have a doctor on staff who could update it for them. In response, Philips and his team helped several EMS providers update their protocols.
There are similar programs in other parts of the state and elsewhere, such as Louisiana and Arkansas. Beauchamp said he would like to see it become more widespread with the help of research showing where it would be most effective.
“I’d love to see every EMS unit have the ability to uplink to the service hospital they work with,” Beauchamp said. “It’s the next step on the tier of emergency care trauma centers.”
Butch Oberhoff, president of the Texas EMS Alliance’s Board of Directors, applauded the bill, saying it goes further than telehealth — it also provides close to pinpoint locations for people calling 9-1-1 on a cellphone and can be used as an educational tool for new paramedics.
“Imagine people who don’t do CPR all the time or haven’t done it on a real patient, even if they’re certified,” Oberhoff said. “We have amazing professionals who are very well trained that can coach them through that.”
Oberhoff added that as the health university expands and improves on the program, it could become a model for others.
“Other states are going to be watching to see how it works and to hear about the success as it relates to first responders,” said Oberhoff.
The act goes into effect on Sept. 1. The program will be paid for by fees collected on certain telephone accounts that pay for 911 services. A fiscal analysis prepared for lawmakers expects the program to cost about $250,000 a year for the next five years.
With the program starting back up, Philips said the focus will likely start in the Trans-Pecos region again, with the goal of building it out so more rural communities can adopt the practices.
“In urban areas, the problem is distance, but out here, it’s time,” Philips said. “So how do you get people to the right place at the right time? We’re using the power of technology.”
Disclosure: Texas Tech University and Texas Tech University Health Sciences Center have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
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This article originally appeared in The Texas Tribune at https://www.texastribune.org/2023/08/25/texas-ambulances-telehealth-funding/.
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