EMS organizations may shy away from starting a community paramedic program because they fear they can’t spare the paramedics. Amidst the paramedic shortage, this is an understandable concern. The next logical question is: can EMTs work in Community Paramedicine?
While EMTs don’t have the same training or scope as paramedics, they are an asset to public health and certainly have a home within the structure of community paramedicine. There are multiple mobile integrated healthcare-community paramedicine (MIH-CP) care models that don’t require advanced skills. However, it’s also possible for EMTs to receive additional training, which prepares them for a role in community paramedicine.
Many areas have already employed EMTs in mobile integrated healthcare with good success. Below, we’ll discuss some of the ways EMTs work in community paramedicine, how they’re certified, and the effects they can have on public health.
How EMTs Fit Within Mobile Integrated Healthcare-Community Paramedicine (MIH-CP)
EMTs receive around 200 hours of training, whereas paramedics receive around 2000 hours – of course, this varies. Regardless, due to this large difference in training, many people might wonder – why use EMTs when we have paramedics? There are many reasons.
First, as we already mentioned, paramedics are in short supply. However, there are good reasons to use EMTs in a community health capacity even beyond this.
Here are several:
- Your community paramedic program is booming. If your community paramedic program is growing, EMTs can help fill staffing holes. Essentially, they add inches to your arms and give you a longer reach. You can reserve the paramedics for advanced patients and use EMTs for less involved cases.
- Your community paramedic program isn’t booming. If your community paramedic program is struggling to get off the ground due to budget or personnel, you can use EMTs to get the program started.
- EMTs may have more desire to become community providers. Certified paramedics spend several full years becoming skilled emergency responders. They may be hesitant to transition to a primary care role – especially at the beginning of their career. Let’s flip the coin – EMTs may have only been in school for several months, meaning they are less invested in the emergency career path and may be enthusiastic about becoming a community provider.
Community EMTs understand risks and recognize when a patient needs further medical attention.
How Can EMTs Benefit Community Health and Primary Care?
This section will talk about several programs and tasks that are often a great mesh with the EMT’s training and experience. The things we list below are real-world examples of how programs around the country are employing EMTs in their mobile integrated health programs.
Here are several situations where EMTs can help MIH-CP:
- Wellness checks. Many patients need regular visits to ensure their vitals and general health are stable.
- Discharge follow-up. After a patient leaves the hospital, it’s helpful to follow up with the patient to ensure they can adhere to discharge instructions.
- Risk assessment. Patients fall and hurt themselves due to hidden risks. EMTs can help find them and fix them.
- Medication compliance. EMTs can help patients stay on their medication schedules and ensure they have access to all prescriptions.
- Confirming food access. Some people struggle with quality nutrition. EMTs can ensure these patients get quality food.
- Facilitating video calls with physicians. EMTs can be the hands of a physician during a virtual check-up.
Those are a few of the practical skills. However, there are also some broader programs that work well with EMT-level providers.
Community health programs for CEMTs:
- Post Overdose Response Teams (PORT)
- Mental health and crisis response teams
- Homeless outreach programs
- Many more!
Let’s shift to reverse for a moment and talk about how EMTs are trained and certified for community health and primary care.
Note: We all know how hard it’s been to find and retain paramedics. For some helpful tips and suggestions, read our guide on how to recruit more paramedics.
Requirements to Become a Community Emergency Medical Technician (CEMT)
So, you’ve decided it might be wise to enlist more EMTs in your community paramedic programs. How do you do it? How are they trained?
Since community paramedicine is still in its relative infancy, there is not yet a nationally enforced standard of training for community EMTs. However, that could change quickly, and some states do have their own certifications for EMTs.
For example, Minnesota certifies community EMTs with several criteria. Below, we will highlight some of their stipulations.
Common requirements for community EMTs:
- Current certification as an EMT or AEMT (advanced EMT)
- At least two years of experience as an EMT
- Applying for certification as a CEMT
- Completing a CEMT provider course (unknown if this is actually required or only recommended).
As you can see, experience is one of the main factors. Health systems understand that, for a provider to be proficient at their job, they will need to have adequate experience with patients and understand the health system.
The state of Minnesota notes that they do have a CEMT course offered through a college.
The NAEMT does provide a standardized course designed to prepare students for the IBSC certification. However, it appears they only admit paramedic-level providers at this time – this may change in the future.
Note: Many areas allow the EMS agency and medical control to determine who is eligible to work as a community provider. This can work well on an individual level. However, many feel that for community paramedicine to emerge from the shadows and gain mainstream adoption, it must devise a universally recognized training program and certification. As MIH-CP moves forward, we may see more progress in that direction.
Understanding the health system is crucial for community providers, as they need to work well in partnerships with neighboring organizations, and they must be able to take part in coordinating patient care.
Addressing the Downsides of EMTs in Community Paramedicine
Before we get into the nitty-gritty, let’s just say this: everything we discuss here is circumstantial. It’s only a potential downside. With that said, it’s helpful to listen to the criticisms, even if they aren’t fully informed.
Below, we’ll tackle several things people commonly question about EMTs in community paramedicine (many of these go for paramedics too).
Here are several possible critiques of EMTs in MIH-CP:
- Lack of training in primary care
- May spread departments too thin
- EMTs aren’t interested in the role
Let’s look at this in more depth and offer some solutions.
Lack of Training
Some people point out that EMTs and paramedics are not initially trained in primary care. And, it’s true, EMTs and paramedics receive most of their training in emergency care. However, that doesn’t mean they don’t have a solid foundational knowledge for further growth and education.
Yet, there is a good point here: neither EMTs nor paramedics should be pushed to do something without the right training. Community health and primary care demand a different skill set – requiring respect and training.
If providers are pushed too fast, too soon – before education has caught up – this will cause needless errors and stalemate the entire community paramedicine movement.
EMTs and paramedics should not be pushed to do anything before they are trained and confident.
May Push Others Out
Some of this criticism may come from those in the home health nursing field, who may feel that community medics and EMTs are “taking their jobs.” However, this thinking represents a fundamental misunderstanding of community health.
EMTs and paramedics are there to work with nurses and to fill holes if there are any – they do not seek to provide an unneeded overlap in care or push anybody out. If that’s happening, that’s not good community health.
If you want to learn more about RNs and medics, read our article on the difference between home health nurses and community paramedics.
Lack of Interest in the Role
Some fire departments and EMS agencies may feel that their staff lack interest in a community health position. This will vary depending on the area of the country. Often, there is strong support for community paramedicine, and the staff is excited to try something new.
However, there are a few hang-ups that could dampen interest.
First, if the EMTs and medics aren’t properly trained, they will lack confidence in the role – naturally making them shy away.
Second, if the EMT must undergo further training and certification but isn’t rewarded with increased compensation, it will be difficult to generate long-term interest.
Final Take on EMTs in Community Paramedicine
EMTs can play a key role in community paramedicine. Though paramedics and EMTs are the heart of an MIH-CP program, they can only function at peak levels if they are properly connected with partners.
Julota exists to build a network where providers can seamlessly and safely share patient data. We can all agree that community EMTs and primary care physicians will function best when reading from the same playbook.
Contact Julota to see how their award-winning tools can make your community health programs more effective. The team would be happy to show you around and answer all your questions!
Also, if you’re thinking about starting a community paramedic program, read our article on the seven steps to starting your own MIH-CP program. This will set you on the right track!