Paul Kirchner’s memory is still a little hazy about the day he got hurt in a farming accident in rural Murray County last September. He went to help a friend who had hit a power line while they were combining a cornfield. 

“I think I was in shock from being electrocuted,” Kirchner, 66, said. “Because it was 7,200 volts that went through me.”

His friend died. But Kirchner was able to call for help and an ambulance soon arrived. As the ambulance crew worked on him, he realized there was someone else in the vehicle.  

“The doctors there on the screen, they were monitoring my vitals and all that stuff,” he said. “They were keeping an eye on that while the EMTs were working on me to get an IV in and stuff like that.”

Kirchner was one of the first patients treated through a grant-funded pilot program in partnership with Avel eCare EMS. The technology allows remote access by medical professionals based in South Dakota. They provide real-time guidance to emergency responders in the field. 

Murray County Ambulance in Slayton is the first Minnesota ambulance agency to use Avel eCare EMS. Wabasso recently launched its program too. 

The company started in South Dakota in 2022 as a partnership with the South Dakota Department of Health. More than 70 ambulance systems in South Dakota were outfitted with two-way audio and video equipment.

Rebecca VandeKieft, vice president and general manager of emergency services at Avel eCare said the system is not a replacement for ambulance service. “Of course, we want those out there taking care of their communities each and every day. But, could we be the gap coverage? Yes. We believe we’re the solution.” 

Every second, every mile

Murray County Ambulance trains regularly with Avel eCare EMS medical professionals. They guide first responders via an iPad installed in the back of the ambulance. Crews are also testing out a portable tablet for use inside of patients’ homes or on sites where vehicles can’t get close.  

Murray County Medical Center Ambulance Director Jennifer Kirchner — no relation to patient Paul Kirchner — said this technology has the capability to save lives, especially in rural communities with limited access to specialized care facilities.

“If we need to call our surrounding services who take advanced-life support (ALS) transfers, it takes at least 30 to 45 minutes to get them rolling,” Kirchner said. “So then, they’re not coming here until half an hour’s passed. So, if we can call while we’re still on-scene and get them coming, they’re going to be here that much quicker.”

Avel created a partnership with Southwest Minnesota EMS which provides ambulance services in its 18-county region. 

“Our patients deserve this,” said Ann Jenson, Southwest’s executive director. “We don’t have all the specialties out here and we don’t have shorter distances to hospitals,” Jenson said. “But if their health care can start almost on patient contact, just think what a service to these patients that we’re giving them.”

Tyler Price, medical director of Avel eCare Emergency, said it does seek to help fill in gaps and support with resources where it can. 

“Hearing that from a trauma perspective and trauma surgeons’ perspective [who] work at tertiary centers that it’s reassuring that we’re doing the right things by the patient and that’s ultimately what our intent is,” he said.

Rural communities are losing ambulance coverage partly due to lack of volunteers and burnout. Some communities have lost their hospitals, and might not have specialty care. Some towns only have one physician. 

Dylan Ferguson is executive director of Minnesota’s Emergency Medical Services Regulatory Board. He said more rural hospitals in the state are adopting telehealth to provide specialty care. 

“There are a lot of people watching this right now,” Ferguson said. “And it’s a case where I think that we are in store to see more interesting things to come and more innovation within the field to help improve pre-hospital care across our state.”

A comfort

Accident survivor Paul Kirchner said his virtually-aided ambulance team called a helicopter within the first few minutes of his care. It flew him to the Twin Cities. He believed technology made all the difference. 

Kirchner said that he knew because of the people who were with him that day — in-person and on-screen — he was in good hands. 

“It kind of was comforting to have that on the screen up above me, just for the fact you had a doctor present,” Kirchner said. “It did give me a very good sense of relaxing me, calming down a little bit … it was very comforting to have that there for me.”