EMS Services – Report of August 15, 2017

Guest post by Albert Berger, LIHD Commissioner

Report of August 15, 2017 Meeting of Lopez Fire District (San Juan Fire District #4) Board of Commissioners

I attended the August 15th meeting of the Lopez Fire District Board of Commissioners and came away encouraged that there is progress between the Fire District and UW Medicine regarding Emergency Medical Services (EMS) once the Lopez Clinic is operated by UW Medicine.

Becky Smith, who is Chair of the Lopez Fire District Board of Commissioners, said that a meeting is scheduled for August 28th, between herself, Chief Ghiglione, Dr. Bob Wilson and the leadership of UW Medicine including Deborah Gussin who is the Executive Director of UW Medicine and Jay Priebe who is the Director of Rural Primary Care Operations. Becky Smith said she was pleased and encouraged that a meeting has been set up to move forward on EMS services here on Lopez and the roles of the Fire Department and the Lopez Clinic in supporting these services. She also said that the UW Medicine appears to be willing to adjust the scope of practice for the Clinic to provide some support for EMS services.

Additionally there was some discussion regarding current airlift practices here on Lopez. Currently airlift is occurring using both the helicopter pad next to the Clinic and also the Lopez Airport. There is concern about safety of the helicopter pad in town. In the future it may be prudent to have airlift operations, whether that is using helicopter or fixed wing aircraft, use the airport. This may mean that airlift patients awaiting transport to the mainland will be supported within the Lopez Fire Department ambulances and/or a room that is appropriate for EMS patients at the airport may need to be developed. It is of interest that on Orcas Island. according to the Orcas Fire Department, that the medical facilities on Orcas are not used to hold patients awaiting transport, but the Orcas Fire District typically supports patients awaiting air transport using their facilities or ambulances.

A look to the future for Lopez Island medical care through the eyes of a physician

Guest post by Jim Orcutt, LIHD Commissioner

As a physician and medical school professor with a background in providing high quality and low-cost services, I would like to make the following observations about the report from the UW on progress toward assuming clinical service operations in the Lopez Medical Clinic in late Sept.

While I sit on the district board as a commissioner, I want the community to know these are just selected items from the report and are not intended to reflect the opinion of the District or other Commission Board Members as I read the update with the eyes of a physician, this is some of what I saw:

  1. Digital Radiology. Investment in digital radiology is wonderful. This will not only allow digital storage of images but also eliminate the use of film based technology with its attendant environmental implication, but will allow transmission to a radiologist with the potential for near real time reading in urgent cases. Definitely will improve the quality and timelines of care.
  2. Advanced Cardiac Life Support(ACLS) will be required of all providers and registered nursing staff. This is exceptional by my experience, typically Basic Life Support(BLS) only is required. I applaud this requirement in a rural setting where it may well be useful in emergent situations. Being an ACLS certified provider (now lapsed as am retired), I understand the implications, including the two day training, testing, certification and required recertification adding to quality of care.
  3. On site lab evaluation for some routine labs will allow near real time data for the providers. Not inexpensive but timely and improves quality.
  4. Telemedicine. While still unclear about what services will be provided, the technology has the capacity to significantly reduce the need for off island travel for some consultations. Possible services would possibly include one/one consultation (e.g. tele-psychiatry), clinical diagnosis (e.g. tele-dermatology) and management of chronic disease using store an forward technology (e.g. diabetic retinal exams). My experience is that patients like and adapt to the technology readily and will definitely improve quality and access to services for islanders.

There were other points as well, however from my view I applaud the UW for taking on such a new and exciting tasks.

Jim Orcutt, MD, PhD
Ophthalmology, Retired