Service Line Update: Community Paramedicine Program

By Candy Skidmore, RN, CHEP, service line vice president, emergency, trauma, CareFlight, and EMS Center of Excellence

The Premier Health Emergency Center of Excellence is excited to offer our physicians the opportunity to refer patients as needed to our Community Paramedicine Program.

Community paramedicine has a variety of models, but the basic concept calls for specially trained paramedics to help communities meet the health care needs of vulnerable residents. Currently, there are more than 100 paramedicine programs in 34 states across the nation. Premier Health collaborated with Dayton Fire Department to offer this program to those residing within the City of Dayton starting this past December. The program is not intended to duplicate or compete with existing resources, such as those provided by home health care agencies.

Our program is intended for patients who have high-risk or chronic illnesses, are taking multiple medications, lack consistency in visiting their primary care provider, or have an increased likelihood of emergency department visits to manage their conditions, and as such being readmitted to the hospital. Additionally, they may have psychosocial, safety, and financial issues that affect their health management. It can be difficult for a provider to know what a home situation is like for vulnerable patients. The Community Paramedicine Program can help bridge that gap and communicate back to the provider.

The community paramedic will visit the patient at home and partner with the provider to set up an individualized plan of care that considers not only health issues, but living arrangements, safety in the home environment, financial limitations, and psychosocial needs. Patients may need assistance with understanding their health care management, obtaining medical equipment or getting prescriptions filled, transportation needs, or even basic food. Additionally, the team can perform wound care, draw labs, give breathing treatments, and other basic medical care. An oversight team meets to review each case, determine needs, a plan of care as well as progress. Randy Marriott, MD, serves as medical director of the program. The patient can be seen as little as one time, or they can be enrolled for 30 to 45 days with several visits each week.

The goals of our program are to:

• Improve overall health management of your patients, and ensure better outcomes and sustainable plans for their health needs, including establishing a primary care physician if needed
• Connect patients with resources to assist them with their needs and set of circumstances
• Improve physicians’ knowledge of their patients’ home environments, including medication usage, health routines, and living habits – all in the interest of improving care
• Improve physicians' knowledge of early warning signs of worsening conditions
• Avoid exacerbating chronic illness through close observation
• Avoid unplanned emergency care and hospital visits
• Reduce 911 calls

While the program is currently offered through a partnership with Dayton Fire Department, Premier Health provides medical oversight and management of the program. Currently, patient referrals are limited to patients living within Dayton’s city limits. All patient visits are documented within EPIC, so they are fully visible to the physician; however, referrals via EPIC are not yet available.

If you have a patient who might benefit from this program or simply wants more information, please contact Laura Clark, RN, manager of the Community Paramedicine Program, at (937) 333-4509(937) 333-4509.

Back to the February 2020 issue of Premier Pulse