Debbie Miller suspected there was something seriously wrong with the 47-year-old caller when the woman started asking about EKGs.
"She wanted to know if an EKG would detect potential heart attacks," said Ms. Miller, a registered nurse working North Arundel Hospital's new Healthline, a resource and information line staffed by trained nurses 24 hours a day, seven days a week.
After asking the woman additional questions, Ms. Miller became convinced she needed emergency medical attention.
"She had a crushing pain in the chest," said Ms. Miller. "She said her left arm was numb . . . all the classic symptoms of a heart attack."
But the woman insisted she might only have indigestion or possibly an angina attack. Ms. Miller convinced her she needed to go to the hospital.
Helping to assess medical problems from earaches to AIDS, the staff on the hospital's newest community service venture, which started July 18, hopes to steer people toward appropriate care as well as away from unnecessary emergency room visits.
"A lot of people are using the ER [emergency room] as a primary physician," said Kay Donald, clinical director of the hospital's Health Information Systems. "If they're calling here with a child with an ear infection, we'll send them to an appropriate place," such as an after-hours pediatric clinic, she said.
Ms. Donald said the Healthline is an important component of "managed care," a concept that centers on avoiding unnecessary and costly treatment. Studies by the U.S. General Accounting Office show that 40 percent of emergency room visits across the country are unnecessary and the patients could have been treated effectively elsewhere, she said.
Healthline staffers sort out the callers between those who need professional care and those who don't, said Jerrold Winchell, director of the service.
"The alternative could happen. They may feel someone needs to go to the ER who doesn't think he has to go." Either way, the hospital hopes callers receive more appropriate treatment, compliments of Healthline.
The service is free. And even though it will cost the hospital about $239,000 during its first year, it's a "win-win" situation financially, said Mr. Winchell.
Patients, particularly those without insurance, get a resource to call for medical advice. And the hospital can reduce unnecessary trips to the ER and refer patients to doctors in the North Arundel Hospital health network.
"By offering the service, maybe they'll choose North Arundel for other services if they need them," said Mr. Winchell.
Another benefit of the line is that hundreds of calls that used to go to the emergency room can be effectively referred to the new service. Mr. Winchell said the ER used to get more than 600 calls a month from people wanting medical advice, a big distraction for ER personnel.
In Healthline's first week of operation, it has averaged about 50 calls a day, slightly higher than expected. Ms. Donald expects the staffing will have to be increased by September.
The line's staff now includes seven trained nurses who alternate on day shifts and 10 emergency room nurses who rotate fielding calls from midnight to 8 a.m. The phone number is 787-INFO.