A waiting room full of tired, coughing patients. The seats are all occupied, and some people are leaning against the wall. An overcrowded ER is standard across America. So how do we fix it?
Community paramedicine is in a position to impact the healthcare landscape. Community paramedicine is much more than visiting patients in their homes. It’s a fundamental shift in healthcare. Instead of bringing the patient into the system – the system goes to the patient.
In this article, you’ll find a list of ways community paramedicine brings positive change to healthcare: relieving the crowded ER and the overrun hospital.
The Problems Emergency Medicine Face
Patients want healthcare. However, staff and budget shortages have led to gaps in communication between patients and healthcare providers.
Several issues have arisen:
- Emergency services used as primary care
- Delayed ambulance response times
- Wasted Funds
Let’s look at each of these in more depth.
Emergency Rooms as Primary Care
While emergency physicians are diversely trained, their primary purpose is an emergency-related illness when working in an ER. As a result, they don’t always have the time to review a patient’s complete medical history and give long-term care advice – this is a job better tasked to primary care physicians.
As a result, the mentally ill patient or the patient suffering from substance abuse doesn’t get the care they need. Likewise, those in the ER for critical illness aren’t receiving the care they need promptly.
Delayed Ambulance Response
Ambulances are already walking a tight line – many companies are experiencing profound staffing shortages. Amidst these troubles, people still call 911 and expect someone to respond. However, many healthcare professionals point out that many 911 calls are non-emergencies.
While these companies are happy to respond, there is a growing realization that EMS needs a tiered response. Some ambulances can stay available for emergencies, and some can respond to non-urgent complaints. When response breaks down, fines ensue.
Community paramedicine is the bridge to reaching this tiered response.
It is often difficult to obtain reimbursement for those stuck using emergency medicine as their primary form of healthcare. Also, the hospital can face penalties if they see a patient repeatedly readmitted.
How can they lower readmission if the patient has no form of primary care?
Community paramedicine offers answers. As we move forward, you’ll see how community paramedics are more than a niche. Community paramedicine and other forms of mobile integrated healthcare have the chance to change healthcare as we know it.
4 Ways Community Paramedics are Making a Difference
Here are several significant ways mobile integrated health and community paramedicine are making an impact:
- Primary care
- Overdose response
- Mental health response
- Building a triage network
Below, we explore each of these in more depth.
1. Bridging the Primary Care Gap
Primary care is the oil that keeps the healthcare engine running. When the primary care network is interrupted, well, just like an engine, things come to a grinding (sometimes explosive and dangerous) halt.
Almost 25% of Americans don’t have contact with a primary care doctor. A Harvard report states that there was a decline in Americans receiving primary care. The pandemic hasn’t helped.
Community paramedics can do a terrific job augmenting routine doctor visits and maintaining the chain of healthcare.
- Reaching those who are rural
- Reducing wait times
- Technology makes it more possible than ever
All right, let’s look at each of these in more depth.
Reaching Rural Patients
Some patients struggle to access primary care in parts of the country where public transportation isn’t an option.
Community paramedics can remove the burden of a long commute to a doctor’s visit. Instead, the community paramedic can bring the services to the patient. As long as there’s no critical illness, the patient doesn’t leave their homes.
Reducing Wait Time
Some patients may choose to schedule community paramedic visits to reduce wait times. Some physician offices become clogged. A patient who already struggles to make the trip ends up waiting hours for a simple check-up, resulting in a whole day spent over a 30-minute check-up.
Community paramedics allow patients to take care of their business at home. Once they arrive, they proceed with the appointment and then move to the next call.
Technology Makes it Possible
Don’t patients need to be seen in person by their physician? It’s true; many patients will opt to see their physicians in person; however, technology has largely removed this burden.
Telemedicine has become common in the United States. Combining telemedicine with trained paramedics almost wholly reduces the need for in-person physician check-ups.
High-speed video chats allow the physician to assess their patient’s virtually. If the physician needs a particular assessment performed, the paramedic can conduct a hands-on exam.
Many patients and physicians find this style of assessment thorough and comfortable.
2. Overdose Response Teams
Primary care is a huge benefit – but it’s not the only way community paramedics can make a difference. Along with the COVID pandemic, the drug epidemic hasn’t gone away – if anything, it’s grown.
Patients trying to fight drug addiction and abuse often struggle to follow up with appointments or reach out for help independently. And if they do, they are met with red tape and more phone numbers to call.
Community paramedics partner with post overdose response teams or PORT to give patients a chance to recover.
Here are a few ways the PORT works:
- A team of mental health and addiction recovery specialists
- Respond to Narcan reversed overdose within 72 hours
- Offer resources for patients and transport them to facilities
Community paramedics are in a unique position to reach out to people with drug-related health issues.
3. Mental Health Response
Similar (often hand in hand) to patients with drug addiction, many patients struggle from recurring mental health crises. Unfortunately, the statistics for mental health have not been encouraging.
As a result, more ambulances are responding to mental health patients. These are often legitimate emergencies. How should mental health be addressed? Should it be swept under the rug?
Community paramedics don’t think so. Here are several ways community paramedics help those struggle with mental health:
- Offering crisis response teams. Instead of simply calling for an ambulance, the patients can receive a team explicitly trained for mental health emergencies. In addition, the personnel are often empathetic and equipped to look at the whole picture – not just rush to the ED.
- Alternative destination for mental health patients. The emergency rooms are full of heroic professionals. However, the ER is not always the best location for all patients. We must abandon the cookie-cutter approach when treating a complex issue like mental health. Community paramedics can offer transport to alternative destinations, including rehab facilities and treatment centers.
- Reducing police presence. Most police officers are very well-intentioned when caring for patients with mental health incidents. However, this doesn’t change the possibility that a patient will feel threatened by legal issues during an encounter. For this reason, paramedics are often a good choice as mental health responders, as they allow the patient to speak honestly without the potential for legal repercussions.
See our article on whether community paramedics should lead the way for mental health calls.
4. Building a Triage-Based Network
During a mass casualty incident or MCI, paramedics and fire personnel are taught to set up triage. Usually with three categories – green, yellow, and red.
While emergency departments triage patients as they arrive at the ER, they only triage patients within the department; they aren’t offering alternative destinations.
This is a simple issue of bottlenecking at the wrong location. If we could solve this one issue, all of healthcare would benefit.
Imagine you walk into the bank and tell them you want to mail a letter – they would quickly direct you to the appropriate business, the post office. However, if everyone flocked to the bank to send letters, this would lead to reduced service. Therefore, it’s imperative to look for the right service at the proper location.
In the same way, the community paramedic focuses on triaging patients who don’t need to ER to alternative destinations:
- Urgent care
- Mental health facilities
- Drug rehab centers
- Primary care physicians
- Non-transport, in-home care
These are several options for alternative destinations.
The Current Healthcare Landscape
The current healthcare landscape includes frustrated emergency room staff and ambulance crews. They see patients who don’t get the care they need. When someone asks, is there something we can do? Shoulders shrug.
With a community paramedic program, there is something you can do. You can have patients satisfied with their care and emergency services who have the resources to treat critical illness and injury.
Bringing Everybody Together
Ambulances, law enforcement, hospitals – they are on the same team. What’s the problem? Sometimes they don’t speak the same language.
Sometimes, improving communication is all that’s needed to spark new ideas and create change. For example, military commanders would try to disrupt enemy communication during past wars – knowing that a disorganized enemy would fall.
Healthcare is fighting many enemies. Drugs, chronic illness, mental health problems. Public health must be organized. It must communicate.
Julota offers a system that allows seamless cross-communication between departments. In addition, Julota provides a cloud-based platform that doesn’t require anything fancy to operate. You get a HIPPA compliant method of sharing patient information, and you can access the system from a smartphone.
If healthcare is to undergo a significant change, organizations must unite. Together, EMS, law enforcement, and hospitals can beat the plagues that overwhelm our cities.