Melissa Magstadt, South Dakota Secretary of Health


During the 2022 Legislative session, Governor Noem and the SD Legislature approved three funding initiatives that will infuse up to $20 million into Emergency Medical Services (EMS) in South Dakota.


South Dakota EMS Telemedicine In Motion Logo.

SD Quitline Training and Resources

The South Dakota Department of Health is excited to announce that we are partnering with Avel eCare to implement Telemedicine in Motion for EMS. This statewide initiative is the first of its kind—a pioneering opportunity to advance care to patients and support pre-hospital professionals.


Telemedicine in Motion: EMS is a new program designed to provide telemedicine services to EMS agencies throughout the state of South Dakota. Agencies who participate will be able to install an iPad in the back of their ambulance and use the tool to call Avel eCare's emergency medicine experts who are based in Sioux Falls. Now, whenever the EMS professionals need help, they can quickly call and interact with doctors and nurses while in transit. This partnership was made possible thanks to Governor Noem's leadership and call for increased funding to support local EMS agencies and the communities they serve.This program is a first-of-its-kind in the nation, and will help sustain the future of EMS in our state.



  • EMS professionals call and are quickly connected to the Avel Emergency team via a telehealth-enabled iPad

  • The service is available 24/7/365, when and where it is needed


  • Avel's board-certified Emergency physicians and expert nurses stand by to help the EMS teams

  • Patient outcomes and EMS satisfaction will be closely tracked to ensure Avel is meeting expectations


  • This program uses cutting-edge technology that optimizes connectivity and helps ensure a low drop rate

  • EMS crews can rely on Avel's ability to maintain a connection, even in some of the most remote and rural areas of the state


Please stay engaged and connected with our monthly EMS webinars where we’ll continue to share news regarding this initiative as well as our LIFEPAK and Regional Service Designation initiatives.

Partnership Grant

Who is Avel eCare?

  • Avel eCare is a telemedicine provider (think virtual health care center) based out of Sioux Falls, South Dakota.

  • Its team of expert physicians, nurses, and clinicians are all trained in telemedicine and deliver services to support local care teams and caregivers.

  • Many on the Avel team also have experience with bedside patient care.

  • They believe every person and every community deserves access to healthcare, and they have been delivering high quality telemedicine services since 1993.

What is Telemedicine in Motion?

  • The Telemedicine in Motion initiative provides 24/7 access to a team board-certified emergency physicians and experienced nurses to render emergency care and peerto- peer support for EMS agencies in the State of South Dakota.

  • Avel eCare's goal as the service provider is to, given the geographic and connectivity challenges, deliver the highest quality care possible while ensuring a fantastic user experience.

How Does it Work?

  • Agencies who enroll will have their ambulances equipped with a cabin-mounted telehealth tablet, microphones, speakers, antennas, and cellular boosters to support strong connectivity in the field.

  • This package of technology is well suited to work in noisy, rural environments and has been designed to augment the services and actions of EMS professionals.

  • When responding to a call, the EMS crew can call Avel eCare Emergency and, within moments, the board-certified ER physician and team of nurses will show up on the screen to assist.

When should the EMS agencies call Avel?

  • The Avel team has been prepped on the capacity of the responding EMS crew, their designation as a Basic Life Support or Advance Life Support ambulance, and have a solid understanding of the rig and its layout.

  • Avel's Emergency medicine experts can help with a variety of actions and procedures, ranging from airway management and trauma care, to ECG interpretation and medication decisions, as appropriate.

  • The Avel team can also call the receiving hospital to alert them that a patient will be soon arriving.

How much training will be required?

  • The Avel eCare team will provide training during the implementation phase of the program to ensure end users have the skills and workflows needed to fully benefit from Avel eCare EMS.

  • The training is concise and will not take up much personnel time. Estimated go live training is between one and three hours.

What is the cost to participate in this program?

  • There is no cost to this program. It is funded through a combination of federal American Rescue Plan Act (ARPA) and state general fund dollars. The initial total for this project is $1.7 million.

  • State general funds will maintain annual service agreements contractually – no changes here. The one-time ARPA dollars will be used for the purchase of hardware, software, and installation.

  • Your EMS agency may be responsible for the cost of additional hardware beyond the first set provided by the State.

How will the ambulances maintain connectivity to Avel?

  • In order to minimize dropped calls, the Avel Virtual EMS technology package is equipped with a robust connectivity solution which allows EMS Agencies to roam throughout their service areas between cell towers and carriers.

  • However, even though the system uses an advanced router that cycles between the major carriers to find the strongest signal, this technology has it's limitations. Cell towers do not cover our state's entire footprint, and there will be times when calls drop. When this does occur, the Avel team will be prepared to reinitialize the video encounter as soon as possible.

How will this help?

  • The goal with this project is to ensure that EMS crews are no longer alone. On request, Avel's telemedicine team will use video capability to assess the situation, augment the EMS crew's efforts, or answer questions as EMTs or Medics provide treatment.

  • The Telemedicine in Motion: EMS initiative will ensure pre-hospital professionals can access Avel for a second opinion, helping relieve some of the burden on the EMS crews and sustain the future of emergency medical services in South Dakota.

Can Avel complete run reports for patient documentation?

  • No, this still falls under the scope of your service as an EMS professional.

Can I just call on the phone instead of video?

  • Although video activation is an option, yes – you dictate how you want to engage with and use the program.

What if a patient refuses video?

  • We will respect the patient wishes with the EMS team documenting under the same protocol as any refusal of care. Avel can still engage with the EMS team over the phone, even without the video initialized.

What does implementation look like?

  • Implementation is quick, efficient, and thorough. Your EMS Agency will schedule a set of implementation calls with our Service Line Managers. These calls will cover clinical integration, change management and administrative considerations.

  • We deploy the train-the-trainer model by preparing the EMS leaders to be the subject matter experts for their respective agency in advance of your go-live event.

  • Once these calls are in progress, a team will be dispatched to your agency to install the telemedicine technology in your ambulance.

  • To start, every EMS agency will receive one unit. Then, once the technology has been installed, tested, and approved, we will host an in-person go live training event with your entire agency. This event will review the service, include walkthroughs of the technology, and make sure everyone is prepared to use Telemedicine in Motion.

When the iPad is on, can you see and hear me?

  • During a live video encounter, the EMS team can see the Avel clinicians on the screen and hear them through the speakers. If EMS crews see a blank iPad or only see themselves on the screen, Avel is not live and cannot see or hear EMS.

How do we activate the service?

  • EMS crews activate the service by placing a landline call to Avel eCare's emergency hub using the dedicated EMS phone number. Once Avel receives the request, Avel will call the iPad to activate video the video connection with the ambulance.

Are you watching me or is it recorded?

  • Our team will not turn on the unit unless you or a member of your team call to activate the service. Once the iPad is turned on, it will establish a real-time, live feed between you and the Avel eCare team. We do not record video interactions.


Disparities Grant

For questions or concerns, please contact Marty Link at

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