STEVE INSKEEP, HOST:
This next news story is nothing urgent, but that's sort of the point. The vast majority of calls into the Houston Fire Department are not for fires but for medical issues. And many of those are not urgent, which makes it harder to respond to real emergencies. So Houston is trying something new, using technology to alleviate the strain on first responders. Carrie Feibel of Houston Public Media reports.
CARRIE FEIBEL, BYLINE: It seems like every firefighter you ask can rattle off examples of 911 calls that didn't even come close to being life-threatening.
JEFF JACOBS: Someone once had a spider bite that's 2 or 3 weeks old.
ASHLEY HISTAND: It could be a headache or a laceration.
ALBERTO VELA: She said, well, this medicine's not working. Now you need to take me to the hospital again so I can get different medication.
TYLER HOOPER: From simple colds to toothaches, stubbed toes to paper cuts.
FEIBEL: Those were Houston firefighters Jeff Jacobs, Ashley Histand, Alberto Vela and Tyler Hooper. Hooper drives the busiest ambulance in the city based in a firehouse three miles east of the old Astrodome. Last year, it made more than 5,000 runs.
HOOPER: We make a lot of runs to where it's not an emergency situation. And while we're on that run, we hear another run in our territory. It could be a shooting or a cardiac arrest. And now an ambulance is coming from further away, and it's extending the time for the true emergency to be taken care of.
FEIBEL: It's wasted time and wasted money. The city of Houston estimates that every ambulance trip costs around $1,600. Many of those trips save lives and make sense, but others don't. Lots of people dial 911 simply because they don't know any other way to get help.
(SOUNDBITE OF AMBULANCE SIREN)
FEIBEL: On a recent Monday morning, Hooper drove the ambulance through the rain to an apartment complex near the airport. Inside, a 56-year-old woman in a red tracksuit is sitting on her living room couch.
(SOUNDBITE OF ARCHIVED RECORDING)
HOOPER: Have you seen your doctor?
SUSAN CARRINGTON: (Coughing).
HOOPER: No? OK.
FEIBEL: Susan Carrington doesn't have a doctor. She called 911 because she's had a bad cough for four days, and it hurts to breathe. Hooper goes over her vital signs, ruling out anything urgent.
HOOPER: Your lungs are clear. Your blood pressure's great. Your pulse is good.
FEIBEL: Previously, Hooper might've taken Carrington to the ER just to be safe. But now he has an alternative, a computer tablet loaded with a video chat application. He launches the app, and Dr. Kenneth Margolis appears on the screen.
KENNETH MARGOLIS: All right, can I talk to Ms. Carrington for a second?
FEIBEL: Margolis is a board-certified emergency medicine doctor.
MARGOLIS: So you're having a cough and feeling weak and having some trouble breathing?
CARRINGTON: Yes, Sir.
FEIBEL: Margolis is at the city's emergency dispatch center almost 20 miles away. But he can watch Carrington's face and gauge her reactions.
MARGOLIS: The symptoms you're having now have been going on for a week?
CARRINGTON: It started Friday.
FEIBEL: After a few more questions, he agrees an ER visit isn't necessary. Instead, he gives her another option, an appointment at a nearby clinic for the next morning and a free cab ride there and back.
MARGOLIS: They'll take you to the clinic, and your appointment is at 9:30.
MARGOLIS: Does that sound reasonable?
CARRINGTON: Yes, Sir.
MARGOLIS: OK, I hope you feel better.
CARRINGTON: Thank you.
FEIBEL: This is a radical change for an emergency response system. The city will pay for all of it - the doctor and the cabs and even the appointments - if it will keep less-sick patients out of the ambulance and away from the ER. Dr. Michael Gonzalez directs the program. It only started four months ago, and he says patients like it too.
MICHAEL GONZALEZ: A lot of people are very surprised that they can talk to a doctor directly and have been very happy with that.
FEIBEL: The federal government is helping Houston pay for the program, which costs the city $5.9 million dollars over five years. And Gonzalez says eventually, it should save more money than it spends. And if it works in Houston, the country's fourth-biggest city, it could become a model nationally. For NPR News, I'm Carrie Feibel in Houston.
INSKEEP: This story is part of a reporting partnership with NPR News, Houston Public Media and Kaiser Health News.
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