Paramedic Robin Fike checked her heart rate, her blood pressure and her oxygen.
The house call was part of Geisinger Wyoming Valley Medical Center’s pilot mobile health paramedic program that aims to help patients like Dovin manage chronic conditions like heart failure. Its goals are to reduce emergency room visits and inpatient hospital stays but also to ensure that patients go to the hospital when they need to be there.
Since the program started in March 2014, paramedics have seen about 800 patients throughout the area and have been in contact with about 2,300 patients, according to Dr. David Schoenwetter, director of Geisinger Emergency Medical Services. Paramedics have responded to Luzerne County and the southern parts of Lackawanna and Wyoming counties, he said.
Schoenwetter said the program has reduced hospital visits but in some cases, paramedics may determine that patients need to be admitted to the hospital. The program allows paramedics to assess patients, ensures services are available to them and augments the existing care they receive, he said.
Since it is a pilot program, it is being offered at no charge and Geisinger is absorbing the cost, he said. Geisinger officials received nothing but perfect scores from patient satisfaction surveys, he added.
The house call was appreciated by Dovin, who suffers from heart failure, which means her heart isn’t pumping as well as it should.
“It’s something that’s good to have for somebody like myself. If I have to call them, I know they’ll be here,” she said. “They’re just wonderful. They check everything.”
Dovin wears a left ventricular assist device known as an “LVAD” that helps her heart pump blood throughout her body. She said she has suffered heart problems several times but her worst experience was in 2013, when she was in Geisinger and the Hospital of the University of Pennsylvania in Philadelphia for a total of 48 days.
“I operate by battery all day,” said Dovin, showing her LVAD. “At night, I’m plugged into power with cords from the battery. I have to keep this on 24-7. You can never take this off.”
Her husband Bob, who is also 76 and shares the same birthday as his wife, serves as her primary caregiver on a daily basis. He said Geisinger’s mobile health paramedic program is easier for them than racing to the emergency room when there is a problem, which causes his wife anxiety. Additionally, the problem might not require that she needs to go to the emergency room, he said.
Fike said she and two other paramedics have previously been to Dovin’s home in West Pittston when she wasn’t feeling well and wasn’t feeling up to going to the hospital. Her cardiologist Dr. Sanjay Doddamani, the director of advanced cardiac disease and heart failure for Geisinger Health System, arranged for a home visit from paramedics when Dovin was feeling weak. The paramedics checked that her vitals signs were OK, Fike said.
Primary care doctors also can request mobile health visits and patients may be seen after they are discharged from the hospital or emergency room.
“We normally see the sickest of the sick and they tend to have quite a few medical problems on top of heart failure,” Fike said. “This just helps to keep them out of the hospital. It’s a reassurance for them and it’s a reassurance for the cardiologist that someone has laid eyes on them because the doctors can’t always squeeze them in. Unfortunately, we have a shortage of physicians and we have an abundance of really sick people.”
Some patients may have home health aides but the aides may need 24 hours notice because there is a shortage of them as well, Fike said. She said Geisinger’s mobile health paramedic program is a way for patients to “get a set of eyes on them quickly.” She believes it is the “wave of the future.”
The initiative, called community paramedicine, also is being done in other parts of the country and Commonwealth Health Emergency Medical Services soon will begin a pilot program.
Gary McIntyre, director of operations at Commonwealth Health Emergency Medical Services, said paramedics will start the program in January at Hemlock Farms in Pike County, where there are about 4,500 homes. Like Geisinger’s, the pilot program will be initially offered at no cost to patients, he said.
He has attended several lectures about community paramedicine, including one last week in Las Vegas. He believes the initiative is “up and coming” and it continues to be used in other parts of the country.
If a patient just had knee surgery, he said paramedics would check that the home is safe, the floors aren’t slippery and nothing is loose on the floor and would go over medications, look at the incision and do a safety check. Six paramedics will be available 24/7 and will undergo months of training in areas such as chronic disease management, home safety and medication compliance, he said.
He believes the program will help keep people out of emergency rooms if they don’t need to be there and could offer people educated decisions about whether or not they need to go to the hospital.
“I think it’s a great idea,” McIntyre said. “I think hospitals will welcome it. We have an elderly population and this will do a lot of good for the people in the community.”
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