In Milam County, Texas, residents are being recruited for a backup emergency corps to help fill gaps left by recent hospital closures.
In a program known as VolEMS, volunteers trained and equipped to perform basic life support will be dispatched through a special smartphone app to respond to their neighbors’ emergencies when the county’s three ambulances are unavailable or too far away. 911 dispatchers will contact these volunteers based on their proximity to the emergency location.
The program’s developers from Texas A&M University’s Health Science Center describe VolEMS as an Uber-like app for emergency volunteers.
“The app contacts the closest five responders,” project manager Jennifer Ozmetin says. “If you’re the one who is closest, you’re the one who can make a difference. This whole idea is about neighbors helping neighbors.”
VolEMS, part of an initiative funded by a $10 million Blue Cross Blue Shield of Texas grant, is one of two Milam County research projects the center is conducting to improve rural health care. If successful, the projects could be used as blueprints in helping other rural communities across the country that have lost hospitals and other health care services.
"The team is showing us we have an opportunity to think differently about meeting the health care needs in rural communities."
Texas leads the nation in rural hospital closures with 26 reported since 2010.
“As communities are impacted by hospital and provider closures, we applaud the Texas A&M research team and the volunteers, who are willing to step up an serve their neighbors in need of emergent care,” says Shara McClure, BCBSTX divisional senior vice president of health care delivery. “The team is showing us we have an opportunity to think differently about meeting the health care needs in rural communities by leveraging technology and utilizing creativity to redeploy and rethink existing resources to provide access to care in rural communities.”
Project leader Dr. Joy Alonzo says her team focused on Milam County because of its vastness and lack of emergency services for its 25,000 residents. The county’s two hospitals were shuttered in 2018.
Now, the county’s closest hospitals and specialists are in Temple, Round Rock, Waco and College Station. Round trip, it can take an hour for an ambulance to transport a patient to any of these cities, leaving large portions of the population vulnerable in an emergency.
“The problem is distance,” Alonzo says. “What happens when all three of the county’s ambulances are unavailable? Living in a rural town should not be a health risk.”
With VolEMS, Alonzo’s team is using technology and innovation to help provide residents with lifesaving emergency care, especially in cases of heart attack and stroke, before an ambulance arrives — a time period known as the golden hour.
“Time is of the essence,” Alonzo says. “If I can get you that next level of care, survival goes up.”
Her team aims to recruit as many as 30 volunteers who will receive training in CPR, as well as in basic lifesaving developed by the American Red Cross and American College of Emergency Physicians. Those volunteers could improve emergency response times and the health outcomes of their neighbors with minimal financial investment, Alonzo says, which always has been the goal.
“The whole idea is for us to hand off the program and allow the county to make it what it needs to be,” she says.
Openness to new ideas
About a year ago, Alonzo’s team began working with Milam County officials, who were eager to find sustainable solutions to residents’ health care needs, says Michelle Morgan, the county’s economic development director.
“It’s been seamless as far as a partnership goes,” Morgan says. “They’ve been listening to our needs and researching what’s needed here.”
Besides its two hospitals, the county also lost its specialists. It also lacks an urgent care clinic, leaving residents without options for after-hours emergency care.
“I think it’s terrifying for some residents,” Morgan says, adding that the county has a large population of older people. “We have no illusions of getting our hospitals back. We’re very open to new ideas.”
The COVID-19 outbreak has slowed the start of the VolEMS program, but Morgan says several residents have expressed interest in volunteering.
“It’s very encouraging,” Morgan says. “We’ll need people from all corners of the county to do this.”