City Controller Alan Butkovitz yesterday proposed placing nurses in Philadelphia's 911 call center to provide non-emergency care over the phone to callers who are now being treated by EMS technicians who arrive in ambulances.
Butkovitz said his plan would ensure faster ambulance response times for patients experiencing genuine emergencies and would save up to $2.6 million a year.
Likening his plan to telephone triage - a practice that prioritizes patient care based on the severity of wounds or illness - Butkovitz said 911 callers should be divided into those who need an immediate ambulance response and those who can wait longer or be "persuaded" by nurses not to use an ambulance at all.
"The goal is to separate non-life-threatening calls from those 911 emergency calls that require an ambulance to be dispatched immediately," Butkovitz said.
Many callers would still get an immediate ambulance response under Butkovitz's plan, including victims of shootings or stabbings, patients who are not breathing or having trouble breathing, and all cardiac patients.
Those calling 911 because of flulike symptoms, minor cuts, or other causes deemed by 911 operators not immediately life-threatening would be connected to nurses.
The nurses would then listen to the patient's symptoms and suggest alternate means of getting to a doctor or hospital. Callers would still be free to demand an ambulance, but they would be lower-priority pickups for EMS technicians, Butkovitz said.
Similar systems are in place in a handful of cities nationwide, including Houston and Seattle.
Butkovitz estimated that a "tele-nursing" 911 call center could lead to about 19,000 fewer EMS ambulance trips a year. That would lead to cost savings and quicker response times, he said.
Although the city has increased its EMS staff in recent years, ambulance response times are always a concern.
Butkovitz said he had not yet discussed his plan with the Nutter administration.
Everett Gillison, the city's deputy mayor for public safety, did not return a call for comment yesterday afternoon.
Brett Mandel, Butkovitz's chief opponent in May's Democratic primary election, said the plan raised troubling questions.
"You're going to have City Hall bureaucrats determining who gets health care? God forbid something terrible happens. The city would be exposed to tremendous liability," Mandel said.