As healthcare changes, a paramedics’ role is expanding. Paramedics no longer only respond to emergency situations in the 911 system. They also visit recently-discharged hospital patients or referred patients in their homes or businesses. This kind of paramedicine, called Community Paramedicine, is helping fill gaps in our healthcare system. Community Paramedics are now improving patient outcomes and experiences, and lowering healthcare costs in non-emergent settings. This expanded role comes with additional education, medical oversight, and consistent program evaluation. Partnerships and collaboration with local stakeholders, leveraging established resources, and a patient-centered focus helps ensure success and positive patient outcomes. Community Paramedic programs can focus on a variety of areas of healthcare. Some of these can include:
• Extension of Primary Care
• Patient Care Coordination and Activation
• Avoidance of Hospital and Emergency Department Admission and Readmission
• Chronic Disease Education, Management, and Prevention
• Mental Health Evaluation
• Expanded Public Health Services
• Wellness Programs
• Emergency Department Diversion and Decrease Use of the 911 System
Community Paramedics all across the nation, and in many other countries, are finding that Community Paramedic programs reduce unnecessary 911 calls and saves both patients and providers in their healthcare costs. With the expanded role of paramedics, Ada County provides additional services and programs to those who need individualized medical care in our community.
Betty is a 68-year-old female who was recently discharged from the local hospital after experiencing shortness of breath and was diagnosed with congestive heart failure (CHF). The hospital released her with new diet requirements, a stack of discharge instructions, a slew of new medication prescriptions and a list of upcoming appointments with various providers Betty will need to schedule in upcoming weeks.
When Betty’s doctor was getting ready to sign the discharge paperwork at the hospital, he went over everything with her in great detail and asked if she had any questions. At the time she did not. Yet, days later, Betty started sorting through all the paperwork and now she does have questions, but she’s not sure who to call or how to best schedule her appointments. She hasn’t seen her primary care provider for several years and found out he’s now retired. Betty also has instructions to make an appointment with a cardiologist, but was only give a phone number with no name. Betty is also trying to figure out her new diet requirements, but she’s unsure if any of the food she has at home is OK to eat. The discharge paperwork also indicates Betty should be taking her blood pressure every day and weighing herself, but she has no way to check her blood pressure at home and she doesn’t own a scale. It all seems so confusing.
Betty has also been having issues with her new medications. The bottle says she needs to take two pills, morning and night. But Betty isn’t sure if she’s supposed to take two in the morning and two at night, or just two pills total. Another medication has a different name on the bottle than what is on her hospital paperwork. She thinks it might be a generic, but doesn’t know for sure. Again, Betty isn’t sure whom to call to ask. Would the pharmacist know? Should she call the hospital? 911?
This is where a Community Paramedic can help. Community Paramedics are uniquely positioned within the healthcare system to help patients navigate the process because they work closely with everyone from dispatch, to doctors and nurses in the emergency department, to system partners like fire departments, health and welfare, and everyone in between. And since paramedics have medical education, they can help answer patients’ questions or put them directly in touch with a more appropriate person to find the correct answer.
A Community Paramedic could also assist Betty in managing her new chronic heart issue, teach her healthier habits to keep her from having another heart problem, review her medications with her, connect her with resources in the community and act as an extension of her healthcare team.