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‘Community Paramedicine’ Programs Define New Role for Paramedics as Mobile Caregivers

Programs proliferating around the country treat patients who would otherwise end up in an emergency room.

Paramedics’ traditional role is to rush to the aid of an accident victim or someone in need of urgent care and sometimes transport to a hospital.

That role has changed for some as communities embark on new ways to deliver health care. Whether it’s called “community paramedicine” like the program in Montgomery County, Texas, or “mobile integrated health care,” a program in Harris County, Texas, some paramedics around the country are seeing themselves increasingly as longer-term caregivers, according to a report in the Houston Chronicle

Teams of paramedics in programs like the two mentioned above aid patients who frequently find themselves in an emergency room when in-home care may be better for all involved. In these programs, groups of “adaptable” paramedics ensure the needs of ill patients who may otherwise end up calling 911.

For example, a 77-year-old man was being tended to weekly by a team of two paramedics who helped him sort through about 10 different types of medicine for various ailments and took the man to the doctor when they thought it was necessary. It’s a far different call than the traditional 15 minutes with a patient.

It’s an alternative to 911 services as health-care organizations seek ways to reduce reliance on the emergency response system, which is so costly. The traditional response system is great for those suffering from trauma, heart attacks and strokes but some patients need other options.

There are about 230 community paramedicine programs in the country, according to Matt Zavadsky, a spokesman for MedStar in Fort Worth, Texas, one of the early paramedicine program adopters. He said there were just three such programs in the country when Fort Worth started its program in 2009.

Patients in the programs receive more intimate care, rather than being treated by several different doctors in an emergency room and thus have better outcomes. That’s what is driving the proliferation of the programs. Also factoring in is the Affordable Care Act because it penalizes hospitals for readmissions.

The programs benefit patients who struggle to read or have little education and can’t understand medical instructions when they get home from the hospital. Some are uninsured and their only means of getting care is calling 911. The 77-year-old man would repeatedly end up in the emergency room after fainting because of low blood sugar from not taking his insulin. The paramedicine team saved him the trips.
 

This staff report was orginally published by Emergency Management