Hopkins Access Line and Lifeline Mark 25 Years of Service in Baltimore

To the Johns Hopkins Medicine community

Colleagues,

In the early 1990s, complex patients being transferred to The Johns Hopkins Hospital were transported in ill-equipped and inadequately staffed basic life support ambulances. At the same time, it was difficult for referring physicians in the community to reach a Johns Hopkins physician to discuss patient care or the potential for transfer.

This is the way things were, not just at Johns Hopkins but throughout the health care community in much of the country. At Johns Hopkins we recognized this as an opportunity to do better for our patients, to differentiate ourselves from others and to dramatically improve health care delivery. We needed a unique solution—one that would provide a simple way to connect physicians and result in an expedited, seamless patient transfer to Johns Hopkins. These patient transfers required a level of clinical expertise that did not exist in the transport environment at the time. The solution required changing the care paradigm. Under the existing paradigm, patients received Johns Hopkins-quality care only after they arrived at Johns Hopkins. What would happen if Johns Hopkins medicine was brought to the patient?

And so, with the goal to improve both the transfer process and patient outcomes, in July of 1992 the Hopkins Access Line (HAL) and Lifeline: Critical Care Transport were born in Baltimore. HAL was designed to streamline the referral process. With one phone call, the referring physician could access specialists at Johns Hopkins and arrange for patient transfer. The Lifeline Transport Team was designed to provide safe and efficient patient care during transfer to Johns Hopkins. Lifeline allowed us to bring the Johns Hopkins level of care to patients well before they arrived at one of our facilities. Both programs were groundbreaking. Both were entirely new ideas, and, together they offered the potential to transform care of the critically ill patient during transport.

It became clear almost immediately that these programs were successful beyond expectations. Patient volumes increased, patient outcomes improved, and HAL and Lifeline quickly became the model referral and transportation system. We had created a new specialty: transport medicine.

As HAL and Lifeline enter their 25th year of service, it is clear that these programs were transformational, that they continue to be a critical part of our patient care system, and that they have had a lasting impact. HAL is a key entry point into the Johns Hopkins Health System (JHHS). But in addition to coordinating patient transfers, the HAL team is also responsible for Heart Attack Team activations for several campuses, Brain Attack Team activations, surgical team activations, neonatal intensive care unit transport coordination, and—recently added—coordination of transfers to other JHHS hospitals. Our HAL expeditors interact with physicians, nurses, Lifeline, bed management and admitting staff to ensure a smooth patient flow into our health system.

The Lifeline: Critical Care Transport team has also come a very long way. From the initial "Medic 5" to our current fleet of eight ambulances and a Johns Hopkins-branded helicopter, we provide more care than many emergency medical services jurisdictions. In Lifeline's first years, the team completed about 250 transports per year. Today, the Lifeline team is responsible for 22,000 patient transports annually, moving patients by ground, air and "in-house" on the East Baltimore campus. The level of care provided, the equipment used and the responsiveness of the team—taken very much for granted today—was a revolution when it began. The Lifeline communications center—HopComm—is responsible for coordinating 40,000 patient transports per year, moving patients into and out of the health care system. Lifeline providers have transported about 300,000 patients and have, without question, saved countless lives. Lifeline has made a difference.

Ronald R. Peterson
President, Johns Hopkins Health System
EVP, Johns Hopkins Medicine

Redonda G. Miller, M.D., M.B.A.
President, The Johns Hopkins Hospital

James J. Scheulen, P.A., M.B.A.
Chief Administrative Officer, Emergency Medicine and Capacity Management
Johns Hopkins Medicine