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Community Paramedicine


Using virtual health technologies, we partner with public and private EMS services to help patients be treated in place. This includes the CMS’ Emergency Triage, Treat and Transport (ET3) initiative that rewards participants for the delivery of the most appropriate, high-value patient care.

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In 2019, unnecessary E.D. visits cost the U.S. healthcare system more than $32 billion dollars. Unnecessary E.D. trips and overtreatment adds pressure to all facets of our healthcare system—providers, payers, hospitals/health systems—and most importantly, patients.

Envision’s emergency medicine specialists empower participating EMS services to help patients avoid a transport to the emergency department when they can otherwise receive treatment in place or a transport to an alternate care destination. Together we can help patients to more appropriately utilize emergency medical services, increase EMS efficiency and deliver a patient-centered approach to emergency response by delivering the right care at the right time in the right place.

As a leading national medical group, Envision has the presence, technologies and resources to play a key role in serving patients and partnering with EMS services. We use virtual health technologies and a community paramedicine program supported by our national network of more than 60 EMS medical directors and 3,500 board-certified emergency medicine clinicians serving more than 100 U.S. counties and 20 million patients.

Using two-way real-time audio/video communications, our emergency medicine specialists are able to effectively triage patients, deliver treatment in place for emergent, low acuity patients and recommend alternative transport when appropriate.

Emergency Triage, Treat and Transport (ET3)


  • Quick access to physician-guided clinical decision-making
  • Quality care when and where it is needed
  • Reduced unwarranted transports for low acuity clinical conditions
  • Improved patient and caregiver experience
  • Added flexibility for EMS teams
  • Ability to serve more patients
  • Reduced costs for the healthcare system (patients, clinicians, payors, partners)
  • Improvement in overall population health


  • Directing patients to the most appropriate level of care
  • Facilitated hand-offs between EMS and receiving facilities
  • Provider-patient virtual health technologies
  • National network of EMS medical directors and expert clinicians
  • Start-up training and continuing education for all participants
  • Existing relationship with national and local EMS agencies
  • Access to additional Envision virtual health services
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Mark Gamber, MD, Envision National EMS Director