The Impact on Community Health through EMS Community Paramedicine Programs

EMS is the eyes and ears of the community. Modern medicine recognizes the positive impact community paramedicine has on public health. Long ago, funeral homes operated ambulances. The good-hearted funeral directors and embalmers provided a comforting hand and a fast ride to the emergency room. 

But EMS has changed. In the 1970s, health systems began seeing the benefits of EMTs and paramedics and their ability to provide life-saving care in the prehospital environment. Today, it is not uncommon for paramedics to perform rapid sequence intubation and administer potent cardiac medications. 

With advancements in EMS capabilities, hospital systems and communities increasingly propose other ways EMS programs can serve our communities, way beyond emergency care. 

Indeed, this thinking has sparked a wave of mobile integrated healthcare-community paramedic programs. These initiatives train providers to go directly into patients’ homes, treating their ailments on site, and offer preventative care – like physicians making home calls in the early 20th century. Telehealth is providing these home calls again in the 21st century, with EMS acting as the intermediary.

EMS community paramedicine programs are reducing 911 calls, ER visits, and hospital readmission rates. These programs offer a true win-win: effective care for patients and less financial and physical stress on health providers. 

A draft white paper from the National Highway Traffic Safety Administration suggested that if 15% of 911 patients could be redirected to primary care, it would result in a national Medicare cost savings of over $500,000,000.

Below, we uncover the many ways community paramedicine can make an impact.

 

How Does EMS Community Paramedicine Impact Public Health? 

EMS community medicine programs come in many forms. Each area can tailor its community health program to meet the needs of the people.

Community Paramedicine teams fill many voids but let’s focus on a few ways these programs impact community health: 

In the following sections, we explore each of these teams in more depth. 

1. Mental Health Response Teams 

The COVID-19 pandemic has turned the mental health climate dark. Though the situation is bleak, there are ways to combat growing mental health needs. Through partnerships with local mental health departments, EMS can triage an adequate response. 

Here are several ways: 

  • Alternative transport: Instead of funneling everyone to the ER, the mental health team determines if the patient is a candidate for an alternative destination (perhaps a mental health clinic or rehabilitation center). 
  • Home Evaluation: If the patient is in an unsafe environment, the providers can use this information when determining the course of care. In a clinical setting, patients are frequently hesitant to disclose specifics about their home life. 

These teams tend to be comforting to the patient. As a result, trust is built between the patient and provider. 

In the past, police officers often acted as first responders for mental health calls. However, unless the officer is specifically trained, their presence can cause patient anxiety. As a result, it’s becoming more evident that EMS will be more involved in mental health calls. 

2. Community Paramedicine as Primary Care

Instead of waiting for a problem to develop, community paramedics meet the issue head-on.

In some areas, community paramedics are dispatched to a patient, similar to a 911 call. In other areas, patients have scheduled appointments. 

The goal? Stop the emergency before it begins. 

Here are three ways community paramedics impact primary care: 

  1. Exams and consultations with physicians: Some systems choose to schedule regular community paramedic appointments. These appointments function similar to a routine visit to the doctor’s office – the paramedic checks vital signs performs blood draws and facilitates video conferences with a doctor. 
  2. In-home treatment: Community paramedics are trained in a myriad of skills, often avoiding the need for patients to enter a clinic. Paramedics can perform wound care, maintenance for indwelling medical devices, and medication administration. 
  3. Preventative medicine: COVID-19 provided a tremendous advance in community paramedic activity. Health systems saw the immense value of limiting contact through in-home care. Once the COVID vaccination became available, community paramedics could deliver the vaccine directly to patients’ homes, reducing excessive contact. 

Some areas use the community paramedic model to its fullest – staffing the ambulance with high-level care providers. These providers can provide advanced services on-scene, like CT scans and reading lab values at the patient’s bedside. 

3. Substance Abuse Response Teams

Substance abuse calls are yet another challenge confronting many EMS systems. However, thinking outside the box can lead to increased patient care. 

If someone is struggling with substance abuse, often they reach out to 911. Many paramedics hear patients say, “I need to make a change.” 

The patients arrive at the ER, ready for a change; however, soon they are discharged – with little more than a number to call. Unfortunately, hospitals are not equipped for this type of treatment and can only make referrals.

This model fails to recognize that substance abuse patients need a streamlined response that doesn’t leave their fate in the hands of a phone call. 

Here are several benefits to community paramedic partnership with substance abuse treatment professionals: 

  • Emergency care: When someone is struggling with substance addiction, they may require immediate medical attention. EMTs and paramedics can directly treat an emergency, stabilize a patient, and allow the treatment professional to begin their assessment. 
  • Mental health assessment: An evaluation can begin right away when a mental health professional is part of the team. In the past, the patient needed to go to the ER. Now, professionals can evaluate patients at the site.
  • Alternative transport: If the patient is deemed medically stable, then alternative transport destinations are considered. If possible, some patients can be taken directly to a detoxification center, bypassing the ER.

Now, let’s talk about how mobile integrated healthcare-community paramedic programs benefit EMS agencies and hospitals. 

The Impact on EMS 

Community paramedicine offers a positive impact to EMS and their partners. As the pandemic continues, hospitals and ambulance companies everywhere are reaping the benefits of these programs.

Here are several ways community paramedicine impacts healthcare providers: 

  • Reduced 911 call volume 
  • Reduced ER visits
  • Increased reimbursement potential 
  • Provide a foundation for community partnership

Let’s wade through this. 

Community Paramedics Reduce 911 Call Volume 

Many people shiver at the thought that an ambulance couldn’t respond when 911 is called. Unfortunately, Chicago has been a scary example of an overcrowded 911 system

Many 911 calls could be treated by a community paramedic, freeing other ambulances for life-threatening emergencies.

When super-utilizers are enrolled in community paramedic programs, they feel connected with the healthcare team. Patients no longer need to rely on the emergency department for primary care because they now have a viable lifeline – community paramedicine. 

Fewer ER Visits 

In some areas, EMS is being held for hours, waiting for an ER bed. However, most EMS agencies realize that ambulances and emergency departments are connected, and busy days overlap. 

Many patients who frequently visit the ED are also candidates for community paramedic services. For example, patients who use 911 as a crutch can now abandon frequent ambulance rides, knowing they will have regular community paramedic visits. 

Increased Reimbursement Potential 

Some EMS organizations might ask: “why start a community paramedic program? That’s not what we’re paid to do?” 

More and more health insurance and Medicare providers see the value of in-home care. As a result, they are beginning to give community paramedic programs the reimbursement they deserve. 

As this begins to catch on, community paramedic visits could result in more consistent reimbursement patterns. Many areas realize that if the patients are well cared for, reimbursement will follow. 

If you’re trying to get a mobile integrated health program off the ground, there are many creative ways to fund a community paramedic program

Bringing Everything Together – How Does Community Paramedicine Make the Biggest Impact? 

Lower 911 calls reduced ER crowding, and increased reimbursement possibilities sound almost too good to be true. 

How does it work? How do we take these visions and turn them into reality? 

The same way we build cities, cure diseases, and land on the moon – through partnership and shared innovation. 

When EMS agencies partner with hospitals, everybody wins. The same is true of EMS partnership with mental health agencies and law enforcement. 

Julota provides a network for community partnerships. So often, EMS and hospitals know where they need to go but are unsure where to start. Julota allows everyone to speak the same language so that departments can work together.

Julota allows a safe and legal sharing of health information between authorized parties, allowing all team members to read the same information about their patients. 

Also, Julota provides a platform for all your community paramedic documentation: ePCR integration, mobile integrated health case reports, and interoperable software that can bring organizations together.

Final Words  

Community paramedicine is making an impact on public health, leading the charge against many afflictions plaguing our homes and schools: mental health struggles, substance abuse, and those without access to primary care. 

Community partnerships lead to reduced health emergencies, unclogged emergency departments, fewer 911 calls, and a better work environment for health providers. 

Julota allows the coordination of care to remain unbroken, ensuring your community gets the help they need.