Community Paramedicine article

[DWC295 70]

My link

[DWC295 70]

Brief, but interesting, article on Community Paramedicine around the country and a focus in CO.

[sympathomedic 383]

I like this. Maybe the feds can (gasp) fund a pilot study in a state/region/county and come up with a way to pay an amount for an avoided transport and ED visit. We need to figure out what it costs to avoid a call, and the amount then saved. Then run a trial and see if it eliminates needles ED transfers, and doesn't hurt anyone. If a $500 EMS run to a $500 ED visit, plus $$ for tests and $$ for a return home can be avoided by a medic stopping by and checking up on things, I am for it, even if I have to do it. More skills, expanded practice, better use of my time, less drain on the system, less money spent on this monster we call healthcare and maybe, just maybe a few pennies in my pocket. I am for it, pitfalls and all.

[v85 212]

One question I have is how would you figure out how many visits equal an avoided call? Is it a 1:1 ratio, or something else? It is very hard to prove or quantify a negative.

My second question is operational. The skills mentioned in the article, taking blood pressures, glucose levels, going to pharmacies to pick up prescriptions, etc. are not ALS skills, in fact with the exception of glucometry they are not even BLS skills. Home Health Aides and Personal Care Aides perform the exact same functions.

If EMS agencies and companies want to get into the "community paramedicine" business, I wonder if it would be more cost/manpower effective to hire HHA's and PCA's, than to take highly skilled paramedics off of the road, especially in areas where ALS providers are already in short supply.

Edited September 20, 2011 by v85

[Goose 188]

One question I have is how would you figure out how many visits equal an avoided call? Is it a 1:1 ratio, or something else? It is very hard to prove or quantify a negative.

My second question is operational. The skills mentioned in the article, taking blood pressures, glucose levels, going to pharmacies to pick up prescriptions, etc. are not ALS skills, in fact with the exception of glucometry they are not even BLS skills. Home Health Aides and Personal Care Aides perform the exact same functions.

If EMS agencies and companies want to get into the "community paramedicine" business, I wonder if it would be more cost/manpower effective to hire HHA's and PCA's, than to take highly skilled paramedics off of the road, especially in areas where ALS providers are already in short supply.

Look at Wake County, NC - hands down one of the best EMS systems in the country. They have a similar program. They have senior paramedics that go through an advanced practice program and ride around in a fly car making house calls. I don't recall all the details but they travel to and build relationships with the higher risk populations and frequent flyers. They do evaluations and preform a few basic procedures (like removing sutures and wound care) and assist in the pharmacological management of the patient. I think it's worked very well for them. From where i sit, i really see no one better suited than a paramedic to preform such tasks.

Besides, i can probably count on one hand how many home health aids were of any assistance to me when they activated the 911 system.

[v85 212]

I thought those advanced practice paramedics were allowed to administer sutures too. I also didn't realize it was the same kind of program, for some reason that one seemed a lot more public safety based, while this seemed a lot more social work based.

[ny10570 745]

I like this. Maybe the feds can (gasp) fund a pilot study in a state/region/county and come up with a way to pay an amount for an avoided transport and ED visit. We need to figure out what it costs to avoid a call, and the amount then saved. Then run a trial and see if it eliminates needles ED transfers, and doesn't hurt anyone. If a $500 EMS run to a $500 ED visit, plus $$ for tests and $$ for a return home can be avoided by a medic stopping by and checking up on things, I am for it, even if I have to do it. More skills, expanded practice, better use of my time, less drain on the system, less money spent on this monster we call healthcare and maybe, just maybe a few pennies in my pocket. I am for it, pitfalls and all.

Feds aren't going near this. EMS is still state run.

[TXCHIEF 9]

In Fort Worth, MedStar who is the EMS provider has a similar program which was started in 2009 and was geared towards those individuals identified as high system users and developed individual care plans for each of those patients. As part of that care plan, the enrolled patient receives regularly scheduled home visits by one of their Advanced Practice Paramedics. During those home visits the paramedic provides a medical assessment, ensures the patient is taking their prescribed medications and is following up with an assigned primary care provider. They also provide some often much-needed social interaction for these patients

The goal of the Community Health Program is to reduce the unneeded 9-1-1 calls and EMS transports

[sympathomedic 383]

"Feds aren't going near this. EMS is still state run. "

I agree. But if you control the checkbook, you control a lot.

My stop mom has a 24/7 HHA. Guess what? It runs nearly $100,000 per year. One hundred thousand dollars. To serve a single consumer.

[firedude 985]

This is a great serivce for the residents inside the WECAD District. Check out their website, here.

Lisa Ward, the new Coordinator for the Western Eagle County Ambulance District (WECAD)

Community Paramedicine program.

WECAD has won nemours awards for their great service to their community. Great Job WECAD! Keep it up. MSNBC wrote a great article on this program earlier this month.

DENVER — A select group of paramedics in several states is helping to provide primary health care by making house calls — an initiative encouraged by the federal health care law to address shortages in primary care and cut down on expensive visits to doctors and emergency rooms.

Paramedics filling health care gap as need grows

My only question is the difference between Community Paramedics and a visiting nurse service. I know they are different but offer similar services.

Edited September 21, 2011 by firedude