[T]he University of Vermont Health Network says its flagship hospital will start paying to staff a helicopter in order to transport critically ill patients in Vermont and upstate New York.
The network announced this week that it is in negotiations with Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, to use one of Dartmouth-Hitchcock’s helicopters for transporting patients.
The network’s flagship hospital, the UVM Medical Center, will pay to staff the first responders who work on the helicopter and receive reimbursements from insurance companies for the air ambulance services, the network wrote in a fact sheet.
The air ambulance is part of a new Regional Transport and Transfer System that the UVM Health Network is creating. The system will transport critically ill patients who need specialized care for issues like heart attacks and strokes to the UVM Medical Center.
Dr. John Fortune, the interim medical director of the regional transport system, said the purpose of the system is to transport patients to the UVM Medical Center more efficiently. The patients come from 12 community hospitals that already refer patients to the UVM Medical Center, Fortune said.
The 12 hospitals include two of the network’s Vermont hospitals — Central Vermont Medical Center in Berlin and Porter Medical Center in Middlebury — plus its three hospitals in New York — Champlain Valley Physicians Hospital in Plattsburgh, Elizabethtown Community Hospital in Elizabethtown, and Alice Hyde Medical Center in Malone.
The other referring New York hospitals include Massena Memorial Hospital and Canton-Potsdam Hospital, which a network official says have recently considered joining the network, plus Moses-Ludington Hospital, which will join the network shortly, and Adirondack Medical Center in Saranac Lake.
The other referring Vermont hospitals are North Country Hospital in Newport, Copley Hospital in Morrisville, Northwestern Medical Center in St. Albans, and Rutland Regional Medical Center, according to Fortune.
“This is not a business decision,” said Michael Carrese, a spokesperson for the UVM Health Network. “It’s about improving the care critically ill and injured people need.”
“The vast majority of this involves ground transport,” Carrese said. Currently only 3 percent (of 6,500 annual transports are) done by air. This is also just hospital-to-hospital transport, not picking-up people from the scene of an accident.”
How the program will work
As part of the deal, Dartmouth-Hitchcock Medical Center will have a substantial role in operating the air ambulance and billing for services, and the UVM Medical Center’s main responsibility will be to provide clinical services, Carrese said.
Dartmouth-Hitchcock is a leader in the air ambulance industry. It was the first health system in the nation to develop flight rules and flight patterns, according Michael Barwell, a spokesperson for the Dartmouth-Hitchcock Medical Center.
The hospital’s flight team, called Dartmouth-Hitchcock Advanced Response Team, or DHART, has been in place since 1994. The team regularly travels to hospitals in Vermont, New Hampshire, Maine and Massachusetts, according to the Dartmouth-Hitchcock website, and has historically traveled to upstate New York.
DHART helicopters take about 1,400 flight per year, according to Barwell, often in situations where travel by ground ambulance would be challenging and where time is of the essence. The transfers are usually hospital-to-hospital as opposed to the scene of an accident, he said.
Barwell said DHART has transported patients from all the hospitals in Vermont since 1994, and “because our service area is all of Vermont and New Hampshire, the locations in which DHART transports patients from vary change month to month or even seasonally.”
Fortune said the network has no intention to take over the paramedic industry in Vermont and upstate New York. Indeed, he said the network wants to help strengthen the paramedic industry, which often doesn’t have enough trained workers.
“What the health network is doing is trying to provide assistance, support, help in any way we can,” Fortune said. “We’re certainly not taking it over. We certainly want to help.”
An ambulance ride from Massena, New York, for example, would take three and a half hours by ground transport, Fortune said. Air transport would take about 35 minutes, he said, and, “we think, a better outcome for the patient.”
He said the time difference can be the difference between life and death for patients with heart disease, who had a stroke, or who have suffered major medical traumas like car accidents. He pointed to a recent mass shooting in Las Vegas, where he said timely response made a difference in victims’ outcomes.
“From the time of their injury they’re beginning to die, and I think, unfortunately, we saw that in the past few days,” Fortune said.
“Not trying to get new patients”
News of the air ambulance expansion comes as the UVM Health Network continues to consider expanding its footprint in Upstate New York.
In the near future, one of the network affiliates, Elizabethtown Community Hospital, is taking on Moses-Ludington Hospital in Ticonderoga, New York, a small hospital that has been struggling under a large debt load.
Dr. John Brumsted, the CEO of the UVM Health Network and the UVM Medical Center, said in an interview Friday that the network has also had discussions about affiliation with Canton-Potsdam Hospital in Potsdam, New York, and Massena Memorial Hospital in Massena, New York.
“We’ve had conversations with (Canton Potsdam),” Brumsted said, “and after, some extended discussions, we elected not, mutually, to go forward. We’re still very friendly. We have clinical programs that we do together, but they’re not formally part of the University of Vermont Health Network.”
“I can’t tell you that in the future they might not be, but the conversations we’ve had there just were some differences in approach that made it so that it wasn’t … appropriate,” Brumsted said.
He called Massena Memorial Hospital — which is in the vicinity of Alice Hyde Medical Center — distressed. “I can’t tell you that they won’t come in,” he said. “There’s nothing that is as formalized as a letter of intent or anything that’s as formalized that it would be in the regulatory process.”
“The issue there is that they’re sort of in the same region with Alice Hyde Medical Center,” Brumsted said. “That is the natural geography of the academic medical center in Burlington, so I can’t say that nothing would ever happen there, but right now there’s nothing formal.”
He said it would be difficult to go beyond New York’s St. Lawrence County, where patients who need a Level 1 Trauma Center go to hospitals in Syracuse.
Fortune, the interim medical officer of the regional transport service, said most of the patients that far west would travel to Syracuse. The UVM Health Network service would only pick up patients that far west in a situation where a patient could not make it to Syracuse, he said.
“We’re not out trying to get more patients, by any means,” Fortune said. “This is not a marketing venture, or whatever. The patients are going to come to us anyway.”
