Project Title: Arizona Rural EMS Advanced Telemedicine Demonstration Initiative (AzREADI) Applicant Organization Name: The University of Arizona Board of Regents Applicant Organization Address: 888 N. Euclid. Room 520, Tucson, AZ 85719 Applicant organization web site: (UA) http:www.arizona.edu Funds Requested: $250,000 per year for three years a total of $750,000 Project Description: The proposed Arizona Rural EMS Advanced Telemedicine Demonstration Initiative (AzREADI) will improve access to high quality EMS care by implementing a rural, EMS-based telemedicine program linked to board certified emergency medicine physicians. Recent improvements in wireless broadband capability (FirstNet), allow rural EMS agencies to extend communications and facilitate comprehensive, real-time vital sign patient telemetry and diagnostics to board-certified EMS physicians. The established Arizona Treat and Refer system – with its Medicaid cost recovery - and the proposed AzREADI platform will be timely, feasible, effective, and sustainable. AzREADI will be piloted with two rural EMS agencies with the goals of reducing unnecessary and/or long-distance ambulance transports, assuring high quality and sustainable pre-hospital care, and improving patient satisfaction. Population served: Two rural EMS agencies serving southern Arizona will work with the University of Arizona (UA) Department of Emergency Medicine and the Arizona Rural Hospital Flexibility Program to implement a telemedicine demonstration program (AzREADI), test its ability to improve rural EMS care, and decrease unnecessary air transport costs. The two partner EMS agencies are the Rio Rico Fire and Medical District, serving the rural area just north of the Arizona-Mexico border, and the Sonoita-Elgin Fire District serving rural communities between Tucson and Sierra Vista, Arizona. The UA Department of Emergency Medicine provides medical director oversight for both. Their EMS service areas include 19,941 Arizona citizens and span 792 sq. mi. in southern Arizona. Goals and Objectives: The AzREADI key objectives are to: (1) implement a telemedicine system that two rural EMS agencies will use for two-way video communication with urban, board certified emergency medicine physicians; (2) evaluate whether the proposed system reduces costs and unnecessary EMS transports; and, (3) measure patient and provider (EMS and physician) satisfaction with the in-home telemedicine services.