Tag Archives: ambulance

Tulsa World investigates billing, compensation at ambulance utility

The Tulsa World‘s Ziva Branstetter has, for months now, been doggedly investigating the billing practices of the Emergency Medical Services Authority, an agency that provides ambulance service to many residents in and around Tulsa and Oklahoma City. The service is largely funded by utility fees which, unless users specifically opt out, should cover the payers’ out-of-pocket costs.

Instead, Branstetter has found, EMSA has followed a number of apparently deceptive billing practices, including sending bills that list a “due from patient” balance of something like $1,100, even though that amount is actually covered by the utility fee. It also unilaterally implemented a policy making patients responsible for the balance if they don’t provide insurance information within 60 days, while providing lavish benefits to employees and executives.

Branstetter’s latest efforts have been directed toward innovative ways of proving EMSA’s sketchy billing practices, as well as uncovering the details of benefits given to the public utility’s CEO. For a full list of Branstetter’s stories on the subject, databases and documents, as well as a summary of the issues at hand, visit the World‘s excellent landing page for the investigation.

Are emergency drivers distracted by technology?

“Driven to Distraction,” a New York Times series that looks at the “dangers of drivers using cellphones and other electronic devices, and efforts to deal with the problem,” turns its focus on first responders, such as police and paramedics.


Photo by rKistian via Flickr

Reporter Matt Richtel points out that emergency drivers are often required to use technological gadgets while driving at high speeds and negotiating heavy traffic to get directions and transmit information about patients.

Data does not exist about crashes caused by police officers or medics distracted by their devices. But there are tragic anecdotes.

The New York City Fire Department says ambulance drivers are not supposed to use on-board computers while driving but “medics and E.M.T.’s in New York and elsewhere say that although they are aware of the rules, they do use their on-board computers while driving.”

Lack of equipment, protocol could be deadly

Judith Graham of the Chicago Tribune reports that the city’s ambulances don’t have equipment that can detect whether a heart attack is an ST segment elevation myocardial infarction (STEMI), the most consistently deadly kind of heart attack.heart

Complicating the situation, only about half of Chicago’s hospitals can perform the preferred treatment for STEMI heart attacks – balloon angioplasty – expeditiously around the clock, Feldman said. Yet the Fire Department takes heart attack patients to the closest hospital, regardless of its medical expertise.

In other U.S. cities, that equipment allows paramedics to alert hospitals so that doctors can be fore prepared to treat the patient as soon as they arrive at the hospital. Other cities also have hospitals that are designated as “STEMI ready” and paramedics can bypass closer hospitals to take patients to one that provides appropriate care.

Experts say that without the equipment, “”treatment is often delayed, increasing the chances that the patient will suffer permanent heart damage or die.”

Denver’s ambulance system said to be ‘broken’

Tom Burke Arthur Kane and Tony Kovaleski of KMGH-Denver, used the example of the 33 minutes it took for ambulances to reach a major December airline crash to investigate flaws in the city’s emergency response system.

It took four minutes until the first ambulance was dispatched from Interstate 70 and Colorado Boulevard, which is 19 miles away. That ambulance was dispatched Code 9 — a non-emergency designation where the paramedics drive at normal speeds without turning on lights or sirens.

“There’s no reason that I can conceive of that a response to a confirmed crash of a commercial airliner, that the initial response would be non-emergency for transport ambulances,” said Bob Petre, a long-time Denver Health paramedic, who is president of the union. “It’s unbelievable.”

Sideras, who, along with Lindsey, reviewed documents obtained by the CALL7 investigators, said Denver’s Ambulance system is “broken.”

“There was a true failure in the system,” Sideras said.

Denver Mayor John Hickenlooper vowed the city’s sluggish response would not be repeated.

“When you’ve got a red alert, you still need to send the resources immediately that that situation is going to need,” Hickenlooper said. “It’s unacceptable. You can’t have from the moment the crash happens, an ambulance there in 33 minutes. That will never happen again.”

The Poynter Insitute’s Al Tompkins interviewed Kovaleski about the project. Kovaleski discussed the impetus for the story.

We have known about the problems inside the dispatch center and with Denver Health for nearly a year. Since last May, we have aired almost a dozen stories exposing problems with ambulance response times in Denver. Following December’s plane crash, it was a logical request to see how the ambulance system worked on the night of a mass casualty incident.