Community Paramedicine

[ashleyv93]

I was reading about community paramedicine earlier and I think I understand the concept of it. Please correct me if I'm wrong; Paramedics and EMT's would be used to answer some the calls that come through 911 that are not "worthy" of a trip to the hospital. I was reading about one paramedic who goes out to make sure certain patients are taking their daily meds, or he's giving vaccines to people, etc. Would the more widespread use of community paramedicine have any sort of negative impact on EMS? I can see the positives of not having to send firefighters and paramedics out on a call at 0300 for someone who needs their meds better explained, it would take a burden off of the 911 system. But is there any kind of downside to this system with impacting EMS?

 

[akflightmedic]

Are we worried about the impact on EMS when it benefits society as a whole? When it improves health care delivery? When it saves taxpayer dollars?

Community Paramedicine is the wave of the future, its been tested for a few years now with great success and you will see it continue to grow. Not only is it beneficial for health care access, it saves money, and it offers a different career path within EMS with specialized education, knowledge or training. Where is the downside?

Oh wait! It is going to reduce the number of BS calls you get at 0300...again, where is the downside? It is going to reduce ER overcrowding, ER wait times which is beneficial for the true emergent patients.

Think of it this way...the majority of EMS systems have the frequent fliers. You treat the same diabetic a couple times a month or more, the same vague pain of the eldery man (when he is only lonely and has no resources), so on and so on. Now waht if you had a master list of the frequent callers and instead of waiting on them, you have a paramedic working a day car 40 hours a week, proactively going to these places, visiting them, doing a reminder or just general welfare check? A few minutes in and out or a little more and then extrapolate that minimum time savings now to what would/does happen if the community medic was not doing this...it is a HUGE savings to the overall system, to all parties involved (EMS, city/county, ER, etc).

You may then say, well that is what home care nursing is for. Yes and no. That system is targeting a specific population and not everyone qualifies for it or is in that system. We are not competing, nor are we redundant. Healthcare is a TEAM approach.

What if the local hospital is overburdened routinely or during peak seasons (like Florida in the winter) and that particular hospital decides to provide its own community medics in partnership with the local EMS system or vice versa? When the hospital discharges patients it could send the daily hot list for the medic to touch base with within 24-72 hours.

Why would a hospital do this? Because the way the new insurance and medicare laws it is to their advantage to do so. They get paid less and get penalized more each time a patient is admitted for a recurring diagnosis. Overall, it is far cheaper to actively community medic a system to keep their bottom line in the right direction. Even though we all want healthcare for everyone, this community paramedicine approach is all about the dollar. Quite frankly, I do not care that is the main driver...I am very happy it is happening and there is a benefit to all involved.

Please tell me what your concerns would be and any cons of how this might be a negative?