City Controller Alan Butkovitz Releases a Report that Focuses on Improving EMS Resp


Audit Date: April 21, 2009

Audit Categories

  • Performance
Controller: Alan Butkovitz

Executive Summary


For Immediate Release:
April 21, 2009

Contact: Harvey M. Rice
(215) 686-6696

Click Here to See the Report

Butkovitz’ Report Focuses On Improving EMS Responses
Tele-Nursing would eliminate 18,000 EMS runs –saving lives and reducing costs

PHILADELPHIA – As a follow-up to an earlier performance audit of Philadelphia’s Emergency Medical Service (EMS), City Controller Alan Butkovitz today released a report entitled, Tele-Nursing: Lifting the Burden on Emergency Medical Services. The report focuses on the elimination of an estimated 18,789 unnecessary EMS runs that could save lives and save $2.6 million in costs.

According to Butkovitz, “the goal of incorporating qualified nurses through ‘tele-nursing’ into the 9-1-1 emergency dispatch system, is to separate non-life-threatening calls from those 9-1-1 emergency calls that require an ambulance to be dispatched immediately.”

“Tele-Nursing can provide the City of Philadelphia with the opportunity to save more lives while reducing costs – as well as the stress level on an already strained EMS system,” said Butkovitz. “By eliminating some 18,000 non-emergency EMS runs each year, more EMS units can reach more emergencies quicker. This study is a continuing ‘best practices’ effort by my office to improve emergency response time as well as save money.”

A Controller’s 2007 performance audit of the Fire Department’s EMS Unit found only 60 percent of the ambulances dispatched were reaching those needing emergency medical assistance in less than nine minutes, which is the industry’s standard time. The previous audit also found emergency responses have increased from 165,000 in 1999 to 210,000 in 2006.

Under the current system, an EMS unit is dispatched after the Police Department determines that an incoming 9-1-1 call is either a fire or medical emergency and it has been routed to the Fire Communications Center. Following established protocols, the dispatcher asks the caller a series of questions to determine the severity of the medical emergency. The calls are then categorized as Code Blue, Advanced Life Support or Basic Life Support.

“While calls are prioritized by these three categories, sadly they are not dispatched according to any priority designation,” said Butkovitz. “Ambulances are dispatched based on the time of the call – first come, first served. The end result is that an EMS unit is always dispatched for every single call.”
With a Tele-Nursing system, calls from the Fire Communications Center are divided by the severity of the emergency. If a call is determined to be Code Blue or ALS, an ambulance is dispatched immediately as a high priority incident.

If a call is determined to be a BLS, the dispatch operator asks a series of questions. Then, the operator either dispatches an ambulance as a low priority incident or the caller is redirected to a Tele-Nurse, who can assist with medical advice, help the caller in making a doctor’s appointment and arrange transportation through SEPTA, ParaTransit and/or Taxi Cabs.

Other cities — such as Houston, Seattle and Richmond, Virginia have all incorporated tele-nursing systems into their EMS call centers.

“Prioritizing all 911 fire and medical emergency calls will free up more EMS units, making them available for critical emergencies and in the end, saving more lives,” said Butkovitz. “Every citizen deserves the peace of mind that they or their loved ones will not be put at risk when an emergency response is needed.”

Click Here to See the Report