The city may spin off the Houston Fire Department’s emergency telemedicine program to a local government corporation in hopes of generating enough funding to support the initiative and, perhaps, even turn a profit.

The city’s chief medical officer, Dr. David Persse, and new Fire Chief Thomas Muñoz pitched the idea to a seemingly receptive City Council Public Safety Committee Tuesday.

The full council is expected to take up the proposal Oct. 28.

Should the body approve the idea, the city would create the local government corporation, and then hammer out an interlocal agreement with the board that would allow the corporation to offer Houston’s Emergency Telehealth and Navigation system, known as ETHAN, to other cities.

Persse and Muñoz told the council committee the program potentially could generate more than $9 million for city coffers in five years.

Under the existing program, which the city began in 2014, some residents who call 911 can speak with an emergency physician to determine the best way to proceed before accumulating ambulance and emergency room costs. Callers, for example, could opt to take a cab to an urgent care clinic for a minor affliction rather than use an ambulance to go to an emergency room. 

ETHAN has saved the city approximately $22 million in ambulance costs since 2014 and served more than 37,000 patients, Persse said Tuesday.

Without corporation status or full city support, the program’s current grant funding will expire in February 2025. 

As a corporation, the program eventually would be sustainable without the use of general fund tax dollars, partnering instead with insurance companies and neighboring cities, Persse said. Currently, 200 Houston Fire Department emergency vehicles have access to the program.

“This ETHAN is going to be a critical resource for us, as I said before, a force multiplier that allows us to utilize the resources that we have now to respond to those quote, unquote, true emergencies,” Muñoz told the council committee. 

Currently, the city operates two programs: ETHAN and a system that allows physicians to quickly arrange alternative transportation and care if needed. 

If it appears a caller to 911 may not need an ambulance, fire department personnel can set up a video call with an emergency-trained physician who evaluates the caller. More than 90 percent of the cases on video calls do not need an ambulance, Persse said. 

“For an emergency physician, it is part of their daily duty to quickly assess the patient and determine whether they’re sick of a capital ‘S’ or sick with a lowercase ‘s’, and what would be safe to do,” Persse said.

Persse, one of the on-call doctors, said he has answered calls to advise patients with a twisted ankle, a persisting rash or schizophrenia who needed to renew a prescription.

The average call takes around five minutes, Persse said, during which the doctor can arrange a cab and alert the clinic of the patient’s upcoming arrival.

Overall, the system saves around 44 minutes on each interaction. 

“The emergency rooms are all overcrowded, right? So, when we go to the hospital with this guy who needs a medication refill, it’s not a priority for them,” Persse said. “…Our ambulance is out of service for 45 minutes waiting for a triage nurse to finally get to this guy.”

The program would have more autonomy as a local government corporation. The city of Houston would lease SYNAPSE, the program that allows doctors to coordinate transportation and care, to ETHAN, which then could sublease the program to other counties and cities looking to replicate the program. 

The corporation would have a board of directors to help guide the program’s changes. Persse said one goal would be to partner with popular health insurance companies in part to have quick access to determine what facilities will be in-network for callers. 

Officials estimated a deficit of around $2 million annually for the first two years of the corporation, which the city likely would have to subsidize. They anticipated revenues to grow over time to earn around $9 million in profit in the fifth year. 

Committee members applauded ETHAN’s work and largely voiced support for ETHAN. Public Safety Committee Chair Amy Peck said the program was “absolutely positive” for Houston.

If the city were to deny the program corporation status, Peck said paying for ETHAN through the general fund would be a big task.

“The funding that we were receiving through grants is running out, and so now we’re able to continue this program that is absolutely necessary,” Peck said.

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