Butkovitz: City could save $ with 'tele-nurse'

A city controller's report recommends that the city take some pressure off its 9-1-1 emergency system by routing noncritical calls to a "tele-nurse" who could dispense medical advice and recommend alternatives to an ambulance run.

Controller Alan Butkovitz says three other cities that employ the technique were able to reduce their ambulance trips by about 8 percent.

Tele-nurses in those cities assist in arranging doctor's appointments and alternate transportation, including taxis and paratransit.

"The biggest benefit would be saving lives because all 9-1-1 fire and medical emergency calls would be prioritized, and as a result more EMS units would be available to respond to all critical emergencies," Butkovitz said.

If Philadelphia's experience were similar to that of Houston, Seattle and Richmond, he said, the city could avoid as many as 18,000 ambulance runs a year and save about $2.5 million.

Butkovitz said that many callers would be better served by tele-nurses.

"People want help, and if they feel there's somebody at the other end of the line that's helping them, why would they want to get into an ambulance and wait for hours at an emergency room?" he said.

The controller's study said that if the city adopted the program, it would have to think carefully about quality-control and liability issues.

Butkovitz said that he'll present the report to the Fire Department, which operates the 9-1-1 system.

Fire officials couldn't be reached for comment on the proposal late yesterday.

David Kearney, a veteran paramedic who is recording secretary of the firefighters union which represents EMS personnel, said that he's interested in the idea.

"I think it would be innovative," Kearney said. "There are a lot of questions about it, like what happens if the nurse recommends a prescription and the caller doesn't have money or insurance. But it's worth investigating." *