Developing a Community Paramedic Program

For millions of Americans, a trip the ED may be one of the only ways to receive medical care, whether their condition is truly an “emergency” or not. Populations like the elderly, the chronically ill, the underinsured, and those living in rural areas are disproportionately at risk of not only suffering from conditions that could be managed with preventative care. They are also more likely to be forced to call 911 when in need of medical attention.

These calls and transports for low acuity cases can put unnecessary strain on EMS agencies and ED staff, and often impairs the patient’s care as they sit for long hours in overburdened waiting rooms. This could be solved with transport to a more appropriate facility – or even more preferable, ongoing preventative care – as the best solution for their needs.

Unwarranted ED visits are also prohibitively expensive, with the cost averaging more than $2,000 depending on the state. Recent studies show that 30% of ED visits among patients with common chronic conditions are potentially unnecessary, leading to $8.3 billion in additional costs for insurance companies.

Partnering with EMS to Deliver More Effective Care

As a result, some healthcare payers have begun partnering with EMS agencies and other providers to find more creative solutions to ensure that patients receive the proper treatment at the best location. One such solution, Mobile Integrated Health, involves empowering EMS responders to make onsite treatment referrals and work via telemedicine with local providers to provide more effective care onsite.

An additional approach gaining traction is the creation of Community Paramedics (CP) programs, which look to expand the role of EMS personnel to deliver more preventative health care to rural communities. By offering extra education and training specific to a community’s needs, and using agency down time, EMS agencies can offer more personalized, proactive visits to the most at-risk members and help reduce the number of emergency calls and transports.

Expanding the Role of Paramedics

CP programs in this way not only help drive down the cost of healthcare while offering better patient care, but also help expand the field of paramedics. Today, many universities and state agencies are offering CP courses to help equip medics to take on this new role within their communities.

According to the Rural Health Information Hub, Community Paramedics may be responsible for:

• Providing and connecting patients to primary care services
• Completing post hospital follow-up care
• Integration with local public health agencies, home health agencies, health systems, and other providers
• Providing education and health promotion programs
• Providing services not available elsewhere in the community

Education to Support New Roles

Community paramedics function as members of a patient’s medical home care team. To serve this role effectively, they need additional education and training focused on providing care over a longer period of time, such as for managing chronic diseases, public health issues, community assessments, and more.

Many universities are now offering specialized training, and, as a result, new designations for EMS personnel have been established, such as Primary Care Technicians (PCTs), Community Paramedic Technicians (CPTs). and Community Paramedic Clinicians (CPCs) based on the number of continuing education hours completed.

Funding a CP Program

CP programs are typically funded by ambulance agencies or hospitals, sometimes through grants. Additionally, some Accountable Care Organizations (ACOs) contract with EMS agencies to use CPs or even employ them directly. EMS agencies work with the ACOs or healthcare payers to determine if they will receive reimbursement for CP services. Today, many states provide coverage for CP visits under their Medicaid programs.

Since every community is different, CP programs must be carefully planned and researched based on a community’s specific needs, available resources and partnerships, top healthcare concerns, and other limitations and challenges. It’s important for agencies to build a structure of stakeholder support and buy-in, and fully outline goals and benchmarks to success. Some agencies even chose to hire a professional advisor to help develop their program plan.

Data Supports Success

Just like any new program, it is imperative that high quality data be recorded and reviewed regularly. Metrics of success must be established at the onset of the program, with data recorded to map to these benchmarks, and recorded consistently. This information will help determine any successes or areas for needed improvement and help ensure the health of the program. Even more importantly, this data will help illustrate the difference being made in the community and within the EDs.

Today’s top software tools for EMS agenciescan facilitate more consistent data recording from patient visits, as well as make patient information more readily available for more effective patient care. With configurable forms, drop down menus, instant patient lookup, and access to online databases, more complete electronic patient care reports (ePCRs) can be recorded for each visit. Digital records also mean less time wasted transcribing handwritten notes, tracking down missing records, or crunching numbers in Excel spreadsheets.

Additionally, it’s now easier for hospitals to share information back with EMS agencies to develop a more accurate picture of community needs and patient outcomes. This can assist in creating more specialized training programs for CPs, while also resulting in more accurate field treatments. It’s a win-win situation for both EMS agencies and the patients they see so regularly in the community.

For more information on EMS software that can help you better prepare to run a successful CP program, visit ESO.com/ems.