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Case Study #2 <br />The 9-1-1 call center <br />receives a cell phone call <br />reporting that a man <br />staggered across the road <br />and fell down in the median. <br />The man is not moving. The <br />9-1-1 call-taker routes the <br />call to dispatchers who send <br />an EMS first response <br />paramedic fire engine and <br />police, as well as a <br />paramedic ambulance. The <br />fire engine crew examines a <br />36 year old man and quickly determines that he is intoxicated and drowsy but <br />otherwise uninjured. The man says he is homeless but sometimes stays with <br />friends. They disregard the ambulance and speak with police. They then radio <br />for a local mobile drug and alcohol treatment van. The man is transported to a <br />non-profit alcohol treatment/overnight stay facility. After alcohol counseling <br />and an offer of follow up assistance, the man is released the following day. <br />Instead of the unnecessary interruption of emergency services and <br />expense for ambulance and ED or addition to the uncompensated care <br />burden, the man is referred to the appropriate facility to deal with the <br />problem. Coordination and referral of such cases to social service <br />agencies, rather than traditional medical care is much more efficient and <br />effective. <br />3.4Emergency 9-1-1 and Non-emergency MediHelp Call <br />Assessment and Dispatch Centers <br />A non-emergency (MediHelp) call center would operate in parallel with the existing <br />emergency (9-1-1) center, and may even be housed in the same facility. It is essential that <br />the two centers collaborate closely and develop strong electronic linkages. <br />The non-emergency call center consists of call-takers certified in emergency medical <br />dispatch and trained in the treatment of non-urgent illnesses and injuries. <br />The call-takers at the non-emergency center work with a physician-approved software <br />protocol with advice and direction from a nurse triage supervisor. This center answers <br />calls to a highly publicized community phone number for use by people who believe they <br />need medical attention, but not on an emergency basis. <br />Call-takers would follow the process outlined in the flowchart below (see figure 1). <br />7 <br />