Emergency Medical Technicians’ Perspectives on a Telehealth Facilitator Role to Expand Home-based Primary Care: Pilot Study Results

Abstract

A growing body of literature supports telehealth-enabled emergency medical services (EMS) personnel acting in expanded roles in the pre-hospital setting. While paramedic-based community programs have shown great promise, emergency medical technicians (EMTs), who make up a larger percentage of the total number of nationally certified EMS personnel and generally have fewer options for career growth, are far less utilized. We investigated EMTs’ perspectives on working as telehealth-enabled primary care provider extenders in a pilot program within a home-based primary care program.

Design

Two semi-structured joint interviews were conducted with EMTs who participated in a pilot program. A deductive thematic analysis approach was used to analyze the qualitative data from the interview transcripts.

Setting

A home-based primary care program and EMS agency in downstate New York.

Participants

Four EMTs.

Intervention

The model, called the Mobile Telemedicine Technician program, utilized EMTs with additional training as telehealth facilitators to examine patients in the home and connect them with their centrally located primary care providers.

Main outcome measure

Qualitative data from two joint interviews with EMT participants.

Results

The EMTs’ sentiments from the joint interviews were generally positive in regard to program structure, EMT responsibilities as physician extenders, and having an expanded role in the primary care practice. Three themes emerged from the joint interviews: (1) perceptions of the Mobile Telemedicine Technician model, (2) EMT career mobility, and (3) considerations for future iterations and similar programs.

Conclusions

While the sample size was small, this preliminary study of EMTs’ perceptions of an enhanced, telehealth-enabled role in home-based primary care supports its further study as an additional role for these EMS-trained personnel. Compared to traditional EMS work, this model provided a less physically demanding option that encouraged building clinical expertise and relationships with patients. The results also elucidated the desire for expanding models of this kind and opportunities to learn new concepts like palliative care medicine. Models such as the Mobile Telemedicine Technician program may serve to increase the home-based primary care program workforce while also offering additional career options for EMTs. However, regulatory changes will be necessary for the long-term sustainability of this and other innovative EMT-based models.