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FDNY, H+H praise 911-call diversion program

But EMS union leaders are skeptical

Posted

Since March 2020, more than 25,000 911 calls have been redirected to a city telehealth program designed to reduce the number of unnecessary ambulance transports to hospitals. The program, Virtual ExpressCare, has prevented 12,000 of the unnecessary transports in the program’s more than four years of existence, Health + Hospitals and the FDNY announced this week.   

The program ensures that New Yorkers who dial 911 with a low-acuity problem such as a rash or need for a medication refill are transferred within 30 seconds from a 911 dispatcher to a Virtual ExpressCare health care provider who can help resolve their problem without dispatching an ambulance to the caller. Initiated at the beginning of the Covid pandemic, Virtual ExpressCare was created to take some of the burden off of an EMS corps facing a personnel crisis and has continued to provide limited relief to beleaguered EMS workers.  

FDNY, H + H and city officials lauded Virtual ExpressCare’s success, noting that it’s provided 3,000 non-emergency rideshares for ailing New Yorkers.  

“Virtual ExpressCare offers timely, high-quality healthcare without a trip to the emergency room,” Afsheen Mazhar, the program’s executive director, said in a statement. “By redirecting over 25,000 low-acuity 911 calls, we’re not only easing the burden on our emergency services but also ensuring New Yorkers receive the right care, at the right time, in the right place.” 

FDNY Commissioner Robert Tucker said in a statement the program is a “win for our city.” 

“With skyrocketing call volume that’s reached historic levels, it is more important than ever to offer viable options to the public facing low-acuity medical emergencies,” he said. “By redirecting some of these calls, we’re giving New Yorkers appropriate solutions while at the same time preserving our ambulances and resources for those who need it most.” 

Union leaders displeased 

Many EMS workers still view themselves as working through a crisis as the volume of 911 calls has risen in the last several years without a proportional increase in manpower or the number of ambulances in service. Anthony Almojera, a lieutenant paramedic, said that the ExpressCare program did have some effect, but compared it to “shuffling chairs on the Titanic” given the wider problems he sees plaguing the city’s EMS service. 

EMS workers sometimes contend with over 5,000 calls a day, and Almojera, vice president of the EMS officers union, insists that the FDNY doesn’t have enough ambulances, EMTs or paramedics to handle the calls.  

"If this program is so successful,” he asked, “then why isn't it translating to an availability of units and there's an ever-increasing response time?” 

Medical emergency calls averaged 4,377 every day in Fiscal Year 2024, according to the Mayor’s Management Report, a 2-percent increase from the prior year. The average response time for ambulances was 8 minutes, 16 seconds, up from just under 8 minutes in FY 2023 and from 7 minutes, 26 seconds in FY 2022. 

Oren Barzilay, the president of FDNY EMS Local 2507, which represents thousands of EMTs and paramedics, also said that the program has not done enough to stop the flow of workers leaving the EMS corps due to overwork and low pay.  

"The city is adamantly refusing, particularly the [Office of Management and Budget], to invest in EMS where we can do our own in-house work,” he said.  "They should add more ambulances to the streets so we can respond to these calls."

Barzilay argued that the program may have even contributed to worsening response times because, in some cases, ambulances were dispatched to callers after the transfer to an ExpressCare provider once the provider realized that callers were having an emergency, and not low-acuity difficulties. According to a study on the ExpressCare program conducted in 2020, more than 60 percent of callers who were diverted to telemedicine nonetheless had to have an ambulance dispatched to them.

Still, ExpressCare's use is far more widespread than other telehealth programs in the region and every unnecessary ambulance trip avoided is a respite for EMS workers.

“Every second counts when you call 911, and thanks to Virtual ExpressCare we're ensuring that remains the case,” Mayor Eric Adams said in a statement. “Every day, our administration is working to make this a safer, more affordable city that is the best place to raise a family, and making sure an ambulance is available when a New Yorker needs it most is key to making that vision a reality." 

dfreeman@thechiefleader.com

 

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