Mount Sinai Deploys Emergency Triage, Treat, and Transport Model

Dec. 6, 2022
Five-year pilot from CMS offers telehealth services to select patients who call 911 with low-acuity injuries and conditions

Mount Sinai Health System says it has become the first health system in New York, and one of the first major academic health centers in the country, to offer telehealth services to select patients who call 911 with low-acuity injuries and conditions.

This effort, led by Mount Sinai’s Emergency Medical Services (EMS) in collaboration with its Department of Emergency Medicine, is part of a federal payment model pilot program called Emergency Triage, Treat, and Transport, or ET3.

Mount Sinai ambulances are dispatched to roughly 100,000 911 calls per year. About 10 percent of those calls involve low-acuity patients with conditions such as minor injuries or a cold, or patients who call 911 to get medication filled or want transportation to a doctor’s appointment because they have difficulty coordinating their healthcare. These patients don’t require an emergency room visit; however, EMS is required to bring them there. ET3 aims to keep thousands of these patients from having to go to emergency departments by finding different ways to treat them, saving them hours of time and in some cases thousands of dollars in bills.

“This program is exciting because it’s a new and innovative way for EMS to deliver patient care where they are and connect them to services they need without having to come to the Emergency Department,” said Kevin Chason, D.O., medical director for the Mount Sinai Hospital EMS group, in a statement. “911 is no longer equal to an emergency department visit. Now a mobile medical team can offer more patient-centered options, and in the future it could connect patients to services in addition to telemedicine or urgent care, such as bringing patients to places like a dialysis center or primary care office where the patient is known.” 

When someone calls 911 under this new pilot program, and a Mount Sinai ambulance arrives, the emergency medical technicians and paramedics do their standard patient assessment. If they determine a patient does not require emergency care and meets specific criteria, crews stay on site and use tablets to connect to the Mount Sinai command center. Within minutes, an emergency medicine provider connects with the patient on the screen and provides telehealth care. This service is available 24 hours a day, seven days a week. 

The program will expand beyond telehealth services within the next few months. It will help get patients to a Mount Sinai Urgent Care location for more treatment if an Emergency Department visit isn’t required. ET3 can also connect patients with behavioral health services and help get them to an alternate destination for care. 

ET3 is currently available for two of Mount Sinai’s 16 ambulances which are linked to The Mount Sinai Hospital’s Emergency Department on Manhattan’s Upper East Side. By early 2023, organizers plan to have all ambulances equipped with this service and involve all seven of Mount Sinai Health System’s Emergency Departments. 

“ET3 is a great example of our health system moving from volume to value. We are delivering high-quality care at the lowest possible cost and we are excited about the opportunity that this presents for our health system,” said Nicholas Gavin, M.D., vice chair of population health and clinical innovation for the Mount Sinai Health System, and associate professor of emergency medicine at the Icahn School of Medicine at Mount Sinai, in a statement.

ET3 is a five-year pilot program, but Mount Sinai anticipates this program will continue beyond the pilot phase and that all EMS services in New York City will be able to offer this to any patient calling 911. 

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