WINK Investigates Reporter Olivia Jean, Photographer & Editor Erik Randlov
•8/27/2026
LEE COUNTY, Fla. (WINK) - When Lauren Adema dialed 911 on the afternoon of June 26, she believed she was doing exactly what her husband — a fire captain with more than 25 years in emergency services — had always taught her.
She had severe abdominal pain, rating the pain a 7 out of 10. She was home alone and she believed she needed an ambulance.
Instead of an ambulance arriving at her Lee County home, Lauren says she spent 13 minutes in the 911 telehealth process before speaking with a physician who ultimately agreed she needed emergency care. She says the physician asked if she was capable of driving herself; she said no. Then she said they offered to call a rideshare service, she didn't feel comfortable with that option so she chose to drive herself to the hospital.
WINK Investigates has reviewed Lauren's 911 call, county policies, contracts, internal workflows and interviews with emergency responders and an independent public safety expert.
Together, they raise broader questions about Lee County's partnership with MD Ally, the private company behind the county's telehealth partnership, including how Lee County screens 911 callers for telehealth, how callers are informed that telehealth is an option, and what happens when a telehealth physician determines a patient needs emergency care.
Around 11:45 a.m. on June 26, Lauren says the pain in her abdomen intensified to roughly a seven out of ten. She called her husband who was at work and he advised her to call 911.
"So I called 911. I was in pain. I was crying,” Lauren recalled.
The 911 recording obtained by WINK Investigates confirms Lauren immediately told dispatch: "I'm having very severe abdominal pain, and I need to go to the hospital."
Recording: Listen to the 911 call
The 45-year-old also told the dispatcher she was alone and asked responders to enter through her garage because her dogs were locked inside.
Dispatch then asked two follow-up questions, including whether she had fainted or nearly fainted and whether she had shoulder-tip pain.
Roughly one minute into the call, the dispatcher told her: "Based on your symptoms, I'm transferring you to Lee County 911 telehealth, where a physician can assist you right away. Please hold while I connect you.”
County training documents instruct dispatchers to use nearly identical language when transferring eligible callers to telehealth and require them to remain on the line until the transfer is complete.
Lauren says she never believed she was declining an ambulance or choosing telehealth. Instead, she says she thought answering questions was simply part of the process of getting one.
"I just kept answering the questions because I thought if I answered the questions the ambulance would be sent," she said.
After being transferred, Lauren says she waited on hold before being asked questions about her insurance.
She says she listened to legal disclaimers, clicked privacy links sent by text message and continued answering questions while still in severe pain.
"I'm doing everything they said, because if I just do what they say, the ambulance will come," she said.
Eventually, 13 minutes after she first dialed 911, she was connected by video with a physician.
Lauren says she again explained she was experiencing severe abdominal pain and again asked for an ambulance.
According to Lauren, the physician told her she needed to go to the emergency room immediately and should receive a CT scan.
"He says to me... 'You must go to the ER,'" Lauren recalled.
She says the physician then told her there were no ambulances available in her area to come help her. Instead, Lauren says she was offered a car service if she could not drive herself.
Home alone and uncomfortable getting into an unfamiliar vehicle while in severe pain, she declined.
Lauren says she drove herself to Gulf Coast Medical Center while still in pain.
When WINK Investigates asked how she managed the drive, she answered simply: “I was on autopilot... I knew I needed medical care and I knew that I didn't have anybody, so I was just going to have to be a big girl and get myself help."
She did worry about the risk of driving herself.
"What if something would have, like, immediately happened, and there would have been a car wreck, and I would have hurt somebody or killed them because of my medical situation, that if I did live through that, then that would totally emotionally wreck me," Lauren said.
She says she was eventually evaluated and discharged but two days later, her condition worsened.
Lauren called 911 again. This time, she says she immediately told dispatch she did not want telehealth.
"I kind of immediately started yelling at them that if they sent me to the telehealth... I would consider it an abandonment of care," she said.
An ambulance was dispatched.
Lauren was transported to HealthPark Medical Center, admitted to the hospital and remained there until she was discharged two days later.
Doctors ultimately determined she was experiencing cardiac complications associated with Hashimoto's disease, an autoimmune disorder affecting the thyroid.
"I needed emergent care and I needed to be stabilized in the hospital," Lauren said.
Lauren says the experience fundamentally changed how she views calling 911. She’s lost trust in the system.
She says her goal in speaking publicly is not simply to tell her story but to make sure others know telehealth in Lee County exists before they find themselves in an emergency.
She says, if you don’t want telehealth, “be very commandful that you want an ambulance.”
Lauren's experience is not the result of an isolated pilot program.
Public records obtained by WINK Investigates show Lee County has spent years building an integrated emergency telehealth system designed to divert certain lower-acuity 911 callers away from ambulances and instead connect them with physicians through MD Ally.
MD Ally partners with Public Safety systems across the country to expand their scope of services to include a telehealth response tier.
County officials say the goal of the partnership is to preserve EMS resources, including ambulances, for the patients who need them most, such as life-threatening emergencies.
According to a contract obtained by WINK Investigates, the program has been operating since May 2022. Lee County’s agreement with MD Ally is effective through 2027.
A county spokesperson said more than 4,555 patients have participated in the program and approximately 82.9% of eligible patients consented to telehealth rather than receiving an ambulance response.
WINK Investigates reached out to MD Ally for an interview but have not heard back.
The county contracts with MD Ally, a private company that provides emergency telehealth services to participating EMS agencies.
The contract describes the program as an alternative response for certain 911 callers whose medical conditions are considered low acuity and appropriate for telehealth rather than an immediate ambulance response.
Patients who qualify are connected with a physician who can evaluate them by phone or video, recommend treatment, direct them to another level of care or, if necessary, contact EMS so an ambulance can be dispatched.
The contract between MD Ally and Lee County also establishes an important standard: Patients transferred to telehealth are supposed to be "Safe for Transfer."
According to the contract, that means the patient:
Document: View the contract here
According to a Lee County spokesperson, the process begins when someone calls 911. A call taker asks questions using emergency medical protocols to better understand the caller's situation.
If the call taker determines the situation is “routine or non-life-threatening” and meets criteria established by Lee County and MD Ally via “Safe for Transfer”, the call can be transferred to MD Ally.
An MD Ally concierge then gathers additional information and obtains the caller's consent before connecting the patient with a licensed emergency physician in MD Ally's network.
If the caller does not want the telehealth option, Lee County says EMS will respond.
If paramedics arrive and the situation remains non-life-threatening, a patient who has chosen telehealth can also be connected with MD Ally from the scene.
County records anticipate that not every telehealth patient will remain appropriate for telehealth.
Internal procedures establish a formal re-escalation process if an MD Ally physician determines a patient actually needs an ambulance after the telehealth evaluation. Those procedures direct MD Ally to contact Lee Control so EMS can be dispatched.
MD Ally can also help Lee County callers connect with local health services, like prescription medication services, convenient medication delivery options, mental health support, transportation services, connectivity with social services, and comprehensive follow-up and post-discharge care.
The emergency telehealth option is provided to 911 callers 24-hours-a-day, seven days a week.
According to records WINK Investigates reviewed, the dispatcher appears to have closely followed Lee County's written telehealth transfer script.
County training materials instruct dispatchers to tell eligible callers: "Based on your current symptoms, we are transferring you to Lee County 911 Telehealth, where a physician can assist you immediately. Please hold while I connect you.”
Document: View MD Ally transfer script
The documents also instruct dispatchers to remain on the line until the caller is successfully connected with MD Ally before releasing the call. That did occur during Lauren's 911 call.
County officials have repeatedly told WINK Investigates that participation in telehealth is voluntary.
According to the county, patients may refuse telehealth and request a traditional EMS response instead.
Internal workflow documents also include a procedure for documenting when a caller refuses MD Ally, including an "MDALLY REFUSED" designation.
Document: View MD Ally procedures
However, during Lauren's recorded 911 call, the dispatcher does not audibly ask whether she wants telehealth before initiating the transfer.
Instead, the dispatcher initiates the transfer. Lauren says she never realized telehealth was optional, responding to the dispatcher with, “okay.”
WINK Investigates asked for the entire 911 call. We only received the first two minutes and 33 seconds of the call via a county public records request. Phone logs provided by Lauren and reviewed by WINK Investigates show the call lasted 13 minutes total. The part of the call WINK Investigates did not get was the portion with MD Ally.
Cedric Alexander, a public safety expert and longtime law enforcement executive, reviewed Lauren's 911 call at WINK's request. He has spent decades in public safety and has been a consultant for first responders nationally, helping with police reform following the death of George Floyd.
He cautioned against immediately blaming the dispatcher.
"I don't want to second guess the operator here. They may be doing exactly what they were trained to do," Alexander said. "The service itself, the delivery of the service itself, probably needs to be revisited."
Alexander said what concerned him was how quickly the decision was made to transfer Lauren to telehealth after she reported severe pain.
“When I hear those two questions, my common sense, my common judgment as an everyday person suggests to me that I'm not sure if those are enough questions to make some determination that a person should be moved on to telehealth when they're crying, they're in pain, and they appear to be desperate for help at that moment,” he said.
He emphasized that emergency response systems must balance efficiency with patient safety.
"When someone is in excruciating pain, that requires immediate attention with immediate resources headed their way," Alexander said. “The problem here is this may be a process that needs to be reviewed, revisited, reconsidered. It probably has some benefit for that community, but it appears it may have some risk associated with it.”
Alexander talked about the potential “risk” of the partnership, being particularly concerned with Lauren driving herself to the hospital, noting she could’ve crashed and hurt herself or someone else.
“In this case, this had an ending in which no one was hurt. But do you want to take those types of risk again, where someone is in immediate pain, asking for immediate care, and then there's this long series of triaging, and nobody's in route to you,” Alexander said. “I think that this needs to be looked at seriously, and because it could have had a bad outcome, but fortunately it did not. And I think with that opportunity now, we all have a chance to go back and see what it is we could have done better if we're going to utilize this process.”
Still, Alexander cautioned against assigning blame before all the facts are known.
"I think everyone was trying to do the right thing," he said, adding that the goal should be evaluating whether the system is functioning as intended and maintaining the public's trust. He hopes Lee County officials are taking a closer look.
Lauren's husband, Scott Adema, has spent more than two decades working in fire and emergency medical services. He currently works for the Matlacha/Pine Island Fire Control District.
He told WINK Investigates, even though he works with EMS all of the time, he had never heard of Lee County's telehealth process before his wife's experience.
“This is really not sitting well with me,” he said. “I feel like the system just failed her.”
Scott also said he does not believe there were no ambulances available.
That left him with questions not only as a husband but also as a firefighter.
"I've been doing this for over two decades, and I'd never seen anything like this," he told WINK Investigates. “This was not a call that should have been sent over to telehealth.”
For Scott, the issue goes beyond what happened to his wife. He says the experience has made him question whether other patients could face the same situation without understanding that calling 911 may result in being transferred to a telehealth provider rather than having an ambulance immediately dispatched.
WINK Investigates requested an on-camera interview with Lee County Public Safety Director Ben Abes on July 24, asking about how patients are determined to be eligible for telehealth, dispatcher training and protocols, how consent is obtained, and the safeguards in place to protect patients.
WINK also specifically requested to talk about Lauren's June 26 call, writing that the station wanted to discuss "a recent case involving a patient who was transferred to telehealth after calling 911 with severe abdominal pain who had to drive themselves to the hospital."
On July 27, Lee County Communications Director Betsy Clayton responded, "Due to HIPAA, our Public Safety staff cannot speak about specific cases. That said, you should know that the assertion made in this sentence is incorrect."
The county did not explain which specific part of WINK's description it considered incorrect.
It did, however, offer to make Abes available for a "short interview" to address WINK's other questions. After some back and forth on a date and time, the interview was confirmed for Monday, Aug. 3, at 10:30 a.m.
Following the confirmation, county communications staff said Abes would have approximately 15 minutes for the interview.
WINK's investigative unit then asked whether the county could provide more time, explaining that the reporting involved questions about 911 dispatch protocols, telehealth eligibility, patient consent and overall program safety safeguards. WINK said 15 minutes would not be enough time for a thorough interview, but said it was willing to proceed with the 15-minute window if that was the time the county could provide.
WINK also addressed the county's HIPAA concern.
Due to Lauren authorizing WINK to discuss her medical information with the county, WINK offered to provide Lee County with a signed HIPAA authorization waiver. WINK told the county that would allow Abes to address the specific 911 call obtained by a county public records request and respond to questions about the apparent differences between the county's protocols and what was captured on the 911 recording.
The county ultimately declined the interview.
In a July 31 email, Clayton wrote: "The county has provided WINK pertinent information, and as a medical provider that prioritizes protecting patients' privacy – regardless of whether a patient has a HIPAA waiver – Lee County does not discuss patient information with the media."
Clayton said the county had been responsive to WINK's questions and had provided "extensive information" about how the telehealth program operates.
She then wrote: "The county respectfully declines the interview request."
The county also told WINK that because the station had indicated it would report the county's decision not to participate, WINK should use the statement the county had previously provided "as it stands."
That statement says, “On any given day, Lee County EMS receives 300 to 375 calls, and of those typically two to five lower-acuity patients are given the option to speak with an MD Ally board-certified emergency physician. Those referred calls go through a rigorous quality-control process, and any customer complaints are carefully reviewed for any necessary follow-up actions.”
Lee County has publicly disputed WINK's description of Lauren's experience, but the county has not specified which portion of the account it believes is incorrect.
WINK's reporting is based in part on Lauren's recorded 911 call, her interview with WINK and the account she provided of what happened after she was transferred to MD Ally.
On the 911 recording, Lauren tells the dispatcher she is having severe abdominal pain and needs to go to the hospital. The dispatcher shortly after transfers her to telehealth.
The recording then continues through the transfer to MD Ally.
Lauren has consistently maintained that after the physician told her she needed emergency care, she requested an ambulance and was told none were available. She says she declined a rideshare because she was alone and did not feel safe, ultimately driving herself to the emergency room.
The county has not explained in its written responses which specific part of that account it disputes.
Due to the Lee County-spokesperson declining an interview, Abes did not sit down with WINK to explain the county's version of what happened on the call.
Lauren says she understands that goal but she believes callers should understand what is happening before they're transferred.
She wants people to know “this thing exists.”
For Scott, the questions remain. As both a firefighter and a husband, he says he continues to wonder whether the outcome would have been different had an ambulance been dispatched immediately.
For Alexander, the case should prompt the county, EMS leaders and others involved in the program to sit down and review the process.
"I think it would be helpful if everyone sit at the table together and review this and see what it is we did well and what is it that we can do better," Alexander said.
If you have a story you'd like WINK Investigates to dig into email us at winkinvestigates@winknews.com or call our tip line at 239-344-5074.
