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Louisville EMS Program Saves Money, Provides Better Care

Nationwide, ten percent of emergency room visits are non-urgent. People call 911 or go to the hospital for ailments that could be cured at a doctor’s office or clinic. A majority of these patients are on Medicaid or are uninsured, and their ER visits drive up healthcare costs.

That makes them the target audience for a computer program used by Louisville Metro EMS, which could save both the health care system and patients money, while providing more appropriate care.

911 calls in Louisville are route to Metro Safe. Inside it’s quiet and calm by design because on the other line it’s likely not.

Calls may require any combination of police, fire and EMS; others require none of the above and that population is the focus of the Priority Solutions Integrated Access Management program, or PSIAM, and Louisville Metro is the only EMS agency in the country that uses it.

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Louisville Metro EMS Will Drug Test Staff

Louisville Metro EMS has responded to the recent mishandling of medication by two EMS employees. Now, the agency said it plans on adding an extra level of accountability.

Metro EMS wants to prevent this from ever happening again, said Dr. Neal Richmond, executive director of Louisville Metro EMS.

In the next 30 to 45 days the agency will test all of its employees for drugs in their system, he said. EMS employees are already subject to random sampling, but Richmond said he wants his agency to set an example.

“We want to lock down the field side of it to the extent that anybody who has a problem out there we’re going to offer help. But as I said you can’t work here if there is any question about potential abuse of prescription medications or any other controlled substance,” said Richmond.

Metro EMS and the local Teamsters union are still working on the guidelines that all 250 EMS employees will comply with.

If an EMS employee is abusing medication they can self-report to the agency and, by law, Metro EMS must respect that.

“It’s not a good idea to have an accident and for somebody to find drugs on board. On the other hand if you come forward and you say I’ve been having a problem and I’m taking some drugs that I shouldn’t be, then we have to respect that and get those people to the right treatment.”

Richmond says employees that self-report will be subject to suspension or leave depending on the circumstances. They can also seek support or counseling through Metro Government, he said.

But in recent cases Metro EMS employees did not report their problem, said Richmond.

Metro EMS will also work with Metro Police to make tracking and handling medication more secure, he said.

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Louisville Metro EMS Responds to Recent Activity

Louisville Metro EMS is changing the way it tracks and handles patient medications. This comes after two EMS employees were accused of mishandling drugs. Now the agency will tighten its processes in response, but will still rely on the trust of its employees.

When EMS personnel prescribe medication to a patient, employees are expected to comply with certain protocols to prevent misuse. While the ability to prescribe medication is regulated through the DEA, it’s up to the individual agencies to track and monitor these prescriptions, said Dr. Neal Richmond, director of Louisville Metro EMS.

“How we track and monitor that is an internal process. What I can say is as a result of this case, and identifying that this did indeed happen, we don’t want this to ever happen again. We’re going to make this as airtight and watertight as we can for the future,” said Richmond.

The agency will seek the help of the Louisville Metro Police Department to further regulate EMS protocols. Richmond said he met with Metro PD on Monday and the new protocols will include an extra level of security to prevent further misuse of patient medications.

Richmond wants Metro PD to help regulate the process because the agency regularly deals with discarding narcotics, he said. Metro EMS is treating the situation with urgency and an agreement is likely to be reached soon, said Richmond.

But, the new protocols will still be subject to some level of trust.

“You try the best you can to lock these things down. There’s always an element of trust. In this case there was an egregious breach of trust. It’s something we take to heart. We investigated this very aggressively (and) we’re going to continue to investigate,” said Richmond.

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Fire and EMS Discuss Efficiency and Effectiveness

The Louisville Merger 2.0 fire and EMS subcommittee met for over two hours on Monday. It began with a presentation by Louisville Metro EMS.

It highlighted the agency’s use of new technology and its increased revenue over the past few years. But the agency still relies on fire departments to be first responders, said Walter Lage, chief of Anchorage Fire and EMS.

“EMS needs help from the fire districts and the fire districts need financial help. Now can we get the two of those together I don’t know,” he said.

The subcommittee discussed how both fire and EMS could benefit by sharing technology and saving time and resources, but neither side would say what it would recommend to the mayor.

The subcommittee meets again on Aug. 9. The mayor has asked for recommendations for Merger 2.0 by Oct. 2.

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ResQPODs Now in All Louisville Metro Ambulances

Louisville Metro EMS ambulances are now equipped with new devices that are used to increase the chances of surviving cardiac arrest. The devices are called ResQPODs, and 300 of them are now in each EMS ambulance and fly car at a cost of 30-thousand dollars to the city.

EMS Director Dr. Neal Richmond says the device is well worth the money.

“We might see a doubling in survival rates,” says Richmond, “when you’re talking about two to three percent in a community like this, that might mean at the end of the year, there are another 30, 40, 50 people walking around, which I think is a pretty big deal.”

The ResQPODS work by preventing air from entering the body at the wrong time. Richmond says it increases blood flow to the heart and can help maintain brain function if the heart has stopped.

He says all EMTs will likely complete training for the devices this week.