Allegheny Health Network in Pittsburgh, Pennsylvania has begun a one-year pilot of a novel telemedicine program, one that will allow first responders to connect select patients to a doctor via an iPad rather than actually transporting them to the hospital.

"The benefits of telemedicine to the patient are innumerable, offering direct in-home access to a physician who can see them and talk to them," Richard Gibbons, Director of the Bureau of Emergency Medical Services, Pennsylvania Department of Health, said in a statement. "I’m very excited about the potential of this program and glad to see that it is happening in a community hospital such as Allegheny Valley."

Emergency services crews have already used the technology on one patient, a 59-year-old woman with diabetes who called 911 after experiencing anxiety, sweating and shakiness. After the emergency crew provided her with orange juice and a glucose solution, the woman felt better and told the first responders she didn't want to go to the hospital. They offered her a telemedicine visit, via iPad, and after a short interview the doctor cleared her to stay home.

As more and more hospitals adopt outcome-based payment models, services like Allegheny's pre-hospital telemedicine service, which can save money by keeping patients from being admitted to the hospital unnecessarily, become more and more attractive, particularly to hospitals with Accountable Care Organizations. 

The telemedicine software employed by the hospital could also be put to good use in the case of stroke, which has long been a flagship use case for telemedicine. A specialist can diagnose a stroke over video nearly as well as in person, and by making the decision early about how the patient needs to be treated -- for instance, whether they need to be transported directly to a specialty medical center -- the patient's outcomes can be greatly improved.

"[Telemedicine] can keep patients who don’t need hospital-based care out of the hospital, and it can get patients who need to be hospitalized into the hospital," Robert J. McCaughan, Vice President of Pre-hospital Care Services at Allegheny Health Network, said in a statement. "It can also help a doctor determine whether a patient can be treated at a community hospital, or whether he or she needs to be transported to a destination offering specialized care, such as a certified stroke center."

The technology can be used any time the patient is able to consent to using telemedicine, according to the hospital. Otherwise, first responders will bring patients to the emergency department as normal.

"Telemedicine ... is a rapidly growing component of US health care," McCaughan said. "This exciting innovation in pre-hospital care is just the beginning of how we will be using telemedicine in our health care system in the coming years."