New Program Partners Social Workers With EMS Providers

DALLAS – Since 1975, the staff of the BioTel On-Line Medical Direction Unit housed at Parkland Memorial Hospital has served countless residents of Dallas County who were transported via ground ambulance and received life-saving direction from people they never met. Now, thanks to an innovative new program, a BioTel social worker can collaborate with EMS personnel to provide additional services to patients in need.

The program is designed to assist frequent users of EMS who may not be in need of emergency medical care, but could be helped by referral to various community social services resources. Paramedics who encounter these patients can contact BioTel to enlist support from BioTel’s social worker.

“I always say that social work is a marathon and not a sprint. There are times when it may take five or six months before you have success. It’s not an overnight process, but it’s very rewarding in the end,” says Katie Herrian, LMSW, who serves as Parkland’s first BioTel Social Worker.

Herrian, together with a city’s EMS personnel, can make house calls to determine what type of services may benefit the patient. Each case is different, Herrian says, noting that a person may have chronic medical conditions but because they don’t understand discharge plans from their physician, the problem becomes acute. Connecting the patient to community resources or securing the appropriate level of home care can reduce or eliminate the need to call EMS for assistance in the future.

“There are many times when a patient doesn’t know what services are available to them so they call EMS,” Herrian says. “Although we work very closely together, our roles are different. You wouldn’t expect me to know how to start an IV, and you wouldn’t expect EMS to know what services a patient qualifies for or how to make community referrals.”

The program is a win-win for all involved: Patients receive the appropriate care they need along with referrals to community resources. In addition, EMS is freed up to assist other critically ill patients and costly emergency department visits and hospital admissions can be avoided. But should a hospital visit be needed, Herrian is made aware so that she can follow up with the patient and family.

“We had a patient who was very ill and transported to the hospital. EMS knew she was in the BioTel Social Work Program and contacted BioTel,” says LuAnn McKee, BioTel Program Manager. “Katie was able to look in the chart and saw that the patient’s medications were changed the week before and notified the physicians. Armed with that knowledge they were quickly able to determine what needed to be done to help the patient.”

For more than 40 years, the BioTel staff of nurses, paramedics and physicians has provided critical consultation, advice and direction to emergency medical personnel in the field. “We are always looking at ways we can enhance the service we provide to our EMS partners and social work was the next logical step,” says Melody Gardner, RN, MSN, MHA, Director of BioTel, North Texas Poison Center and Observation. “Our social worker can help navigate through the complicated healthcare environment to connect with agencies such as Adult Protective Services, Child Protective Services, local and county service agencies or insurance providers.” 

BioTel began operations at Parkland on Jan. 3, 1975, when Dr. James Atkins, a UT Southwestern Medical Center cardiologist, along with the leadership of Dallas Fire-Rescue, developed and implemented a new paramedic training program for the city of Dallas. These newly-trained paramedics required rapid access to emergency physicians and nurses for medical consultation and direction, which was provided by UTSW/Parkland faculty and resident physicians along with Parkland staff nurses in the BioTel radio room. This collaboration between Parkland, UT Southwestern and Dallas Fire-Rescue continues today and along with paramedics from the other BioTel cities’ EMS agencies forms the core of the UTSW/Parkland BioTel EMS system.

Parkland-trained emergency and critical care nurses along with paramedics and faculty and resident emergency physicians provide 24/7 coverage for the EMS system that today includes 13 fire department-based EMS agencies across the county. Together they provide 9-1-1 emergency medical coverage for more than 2 million North Texans.

The need for BioTel consultation includes complex medical calls, cardiac arrest resuscitation, hospital destination decision-making, medical-legal issues, medication dosages, termination of resuscitation efforts and assistance with EMS policy adherence. 

In extreme emergencies when a patient requires specialized services during complex extrication, BioTel can dispatch Parkland’s specialized surgical team. In addition, BioTel staff functions as scribes when paramedics are performing complex cardiopulmonary resuscitation in the field and serve as a resource and liaison when a member of a Fire Department or EMS agency is injured in the line of duty.

And now, with the addition of a social worker, BioTel enters a new era.Marshal Isaacs, MD, Medical Director for BioTel believes this is a critical addition to the array of services that BioTel provides.

“BioTel has always sought to provide innovative high quality services to our EMS agencies, providers and patients,” says Isaacs, Medical Director for Pre-hospital Care/BioTel at Parkland, Professor of Emergency Medicine at UT Southwestern and Medical Director for the UTSW/BioTel EMS System.  Now with the addition of Ms. Herrian and this innovative social services program, BioTel can offer additional services that will enhance the effectiveness of our EMS agencies and improve the overall health of our patients and our community.”

For more information about services at Parkland, visit www.parklandhospital.com