Community Paramedicine

1

What is community paramedicine?

The healthcare landscape is changing rapidly. Hospitals, health systems, and insurers are increasingly focusing on efforts to expand access to care for a wider population. There is an accelerating shift toward the concept of value-based healthcare , where providers and facilities are paid based on patient outcomes, rather than the traditional fee-for-service healthcare delivery model. As these movements grow, there is an expanding need for innovative programs and solutions that can fill significant gaps that have come to exist in the larger healthcare system. Community paramedicine (CP) is emerging as such a solution.

CP, also known as mobile integrated healthcare, has existed on a small scale in varying formats throughout the country for over 15 years. The underlying theory is simple: utilize paramedics or EMTs outside of traditional emergency response and transport roles to address some unmet need in a community or for a partnered healthcare element. For many EMS agencies, the application may be as simple as providing an additional service to help reduce inappropriate utilization of the 911 system or an emergency department, an issue that has long been a major challenge for the industry.

However, what is rapidly coming into focus is that community paramedicine’s impact can extend far beyond EMS operations. In the era of value-based healthcare, a collaborative and comprehensive approach to patient care is critical. Consequently, community paramedicine programs are increasingly being created to provide a significant enhancement to ongoing postdischarge support for high-risk patients.

2

What is the scope of community paramedicine?

What makes the community paramedicine concept so compelling is its versatility. These programs can target a wide range of historically challenging problems. In addition to addressing inappropriate system utilization, CP elements may seek to address specific clinical or social issues. Partnerships or integration with hospitals and health systems allow for significant enhancements to acute and chronic disease management and may significantly reduce the occurrence of readmissions or other negative outcomes. These partnerships may also provide for a significant ability to extend primary care to the home of the patient, improving medical access in underserved populations.

As a result of this versatility, operations and interventions will vary from program to program. In general, a community paramedicine assessment will consist of medical evaluation and education, as well as a thorough social assessment. While EMS is highly trained in managing medical needs, a comprehensive approach to addressing social barriers may require additional training or a new perspective. However, it is increasingly obvious that the value of addressing these needs cannot be overstated, and this plays a huge role in improving outcomes.

3

What does a community paramedicine home visit consist of?

In general, most community paramedicine home visits will feature:

• A history review

• Patient education

• Medication reconciliation

• Physical exam

• Social assessment

• Interventions

• Documentation