Applicant: UrgentEMS, Inc
These are just some real scenarios based on providing real-time meaningful healthcare solutions. At every encounter, a triage decision will be made is the patient
2. “Does the applicant employ or contract the physician and ancillarys and are we to provide their medical mal practice coverage? If so, please complete spreadsheet roster.”At this point Dr. Tiffany Najberg Do is our Medical Director with the title of Director of Emergency Products and Services. Additionally, Dr. Najberg will become the Medical Director of our follow-on Subsidiary Clinic to be located at 401 Market St, Shreveport location. From this location, Dr. Najberg will be responsible for directing the mobile clinics as their online medical control. Once the clinic is operational, Dr. Najber will see patients in the clinic. We will be adding paramedics to staff the mobile clinics as demand grows. In the clinic, we will staff for a minimum of 12 hours of operations.
3. When choosing a patient, we will use the following criteria:
4. “Is there any physician between the service and the patient like a PCP.” UrgentEMS will encourage and cultivate a relationship with Primary Care or Specialty Care physicians to participate in our network. We are interested in providing urgent care services on demand and will inform the primary care physician assigned to the patients seen of the care provided. UrgentEMS recognizes that many patients do not have a medical home or primary care physician we will provide limited primary care services through the mobile clinics and the subsidiary urgent care clinic to be located at 401 Market St, Shreveport location. Our proposed agreement with the owners of 401 Market St, Shreveport location is to become the cornerstone clinic to bring other medical clinics and services to the building. Those services and clinics in the building will bring specialty care services that we want to participate in on the telemedicine network. We will have no ownership or financial relationship with these facilities beyond the cost of network services.
5. Our clinicians will reserve the right to prescribe medically necessary medications for:
6. “Do they have first time face to face exam with a physician at a facility location as now required by several states?”Using the mobile clinics in person one on one onboarding process at healthcare onsite employer health fairs, we will employ midlevel providers such as NP and PAs to obtain the face to face exam where required. Reading the authorized scope of practices for paramedics in Louisiana operating a physician extenders with a real-time telemedicine link will for many conditions. Additionally, we will use our subsidiary clinic located at 401 Market St, Shreveport location. We will bring patients for annual face to face assessment as required. In select member patients willing to pay for premium services, we will our physicians go to the patient for their yearly face-to-face assessment with a mobile clinic.
7.” How do they build a Patient history?” Patient histories for members will start with the onboarding processing during health fairs. During this process, the mobile clinic staff will start with a standardized onboarding process obtaining the following baseline information.
For patients who come in as nonmembers, a standardized triage chart will be used to start the telemedicine triage process once the determination of emergent vs nonemergent condition has been made. This process will be done prior to the arrival of the mobile clinic. We will be using the Teleray telemedicine platform with an OpenEMR EMR provided by HealthTech, including an electronic prescription system.
8. What are their diagnostic protocols? Meaning when and how do they determine if a patient should go to the ER, Urgfent Care, or their primary care physician. (as oppesed to writing the scrip themselves or just advising the the patient on what course of action to take by themselves)
The telemedicine triage center will send ALL chest pains to the ER. Patient who are not members with known medical history of COPD and CHF will be sent the ER. For member patient’s with a known history who are not in extremis will be evaluated by the MD or assigned provider if determined to be urgent our mobile clinic will be sent to patient or patient will be directed to the subsidiary urgent care clinic.
NO Chronic pain management medications will be filled patient will be directed to their primary care physician. No ADHS medications will be filled patient will be directed to their primary care physician or a specialist.
Any orthopedic injuries identified as displaced fractures, femur fractures, or probably hip fractures by the telemedicine link will be directed directly to the ER using traditional 911 services.
Mobile Protocols we will use the current Emergency Protocols from Region One in Louisiana as the basis of our Emgency Protocols, we will modify them for a Community Care Model. Additionally we are looking at severel community care paramedic protocols that we will adjust to fit our operations. I am attaching two versions of protocols one emergency and one community care paramedic protocol, along with the Louisiana Paramedic Scope of Practice protocols. Anything not enumerated as a standing order by Dr. Najberg will require online realtime telemedicine consultation with the patient and paramedic present. Where prohibited explicitly due to specific mediations or procedures UrgentEMS will employ roving RNs, Nurse Practioners, or Physicians depending on the level of care to be provided in the field.
After speaking with Dr. Najberg at this time we are not inclined to provide suturing in the field, we are however willing to provide field Dermabond and Zip stitch technologies for superficial wound closures. All would closures will require realtime evaluation by on line medical control. We will revisit suturing in the field at future point and time due the need to for specialized training for the paremedic before these procedures can be approved. Any wounds at this time that require suturing the field shall be reserved for NP, PA, and MDs at this time. Invasive procedures will be referred back to the subsidiary clinic. Invasive procedures available at the subsidiary clinic:
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