Community Paramedicine

The era of “Community Paramedicine” is rapidly expanding across the county and with it comes both successes and pitfalls. Under the umbrella of the “health care system” there are many stakeholders: hospitals, express care facilities, physicians and other health care practitioners, visiting nurse organizations, home health agencies, homemaker services, and EMS providers. EMS is no longer a “stand-alone” component of health care where we simply deliver a patient to a medical facility. Our initial contact with and treatment of patients likely marks their entry into health care – often at extremely difficult and stressful times for them.

With hospitals being penalized by Medicare for readmissions of frequent patients, there are growing opportunities for EMS providers to work with hospitals and other providers in assuring the patient remains at home and compliant with instructions and with administration of medications. Is McGregor in the position to follow-up with these patients upon discharge? I believe so. While this may be in conflict with other agencies, I believe we are in a unique position to provide regular (daily, weekly, etc.) contact with a patient, preferably in person. Can technology be used to provide visual and verbal contact with the patient? Absolutely. Can we be further trained in assessing living conditions at a residence? Yes. Can we facilitate contact with other service providers (Meals on Wheels, social service agencies, etc.) to assure better living conditions? Perhaps we owe it to ourselves to do so.

Nationally, the moniker of “Community Paramedicine” is being supplanted by the term “Mobile Integrated Health Care” that, I believe, better reflects what we can do. While the logistics are many they are not insurmountable as long as all stakeholders keep their “eyes on the ball” – patient care and outcomes – everyone will benefit.

Thoughts? Drop me a note at bcote@mcgregorems.org. I welcome your feedback.