Community paramedicine allows paramedics and emergency medical technicians to operate in expanded roles to provide routine healthcare services to underserved populations and helps improve rural emergency medical services. EMTs and paramedics who are trained in this advanced healthcare delivery role are able to help patients who may need care not usually provided by calling an ambulance service, like providing primary care and helping with post-discharge follow-up care. You’ll notice both of these situations are known to contribute to over utilized emergency departments and unnecessary medical costs burdened by the patient or government funded health coverage.
First responders, EMTs, and paramedics who are interested in providing this additional care are required to be specially trained and the community paramedicine programs must be funded. This typically falls into the lap of the ambulance service or requires grants, which come with their own challenges. But, why should the EMS department shoulder the costs alone when community paramedicine, especially when paired with telemedicine, impacts the entire community? Read below to learn why we believe the entire healthcare community should be involved in community paramedicine.
1- Hospitals benefit from services provided by independent ambulance units and their ability to provide community paramedicine.
Residents of communities where community paramedicine is practiced are often able to be treated on-site, where they have called for an ambulance. Sometimes up to 90% of 911 calls are not due to true emergencies and the reduction of readmissions and emergency department misuse helps to decompress EDs and allows for patients with true emergencies to be seen faster.
For hospitals who often see patients readmitted and have to deal with the repercussions associated with reimbursements, community paramedicine is ideal. Often readmissions are due to poor discharge instructions or patients who cannot follow discharge instructions easily on their own. Paramedics in the field with access to telemedicine services where emergency physicians are available for a quick video consult 24/7 can help get patients back on track with their follow-on care while remaining at home. In addition, minor illnesses and injuries can be treated without a trip to the hospital.
2- Primary care providers see less of a gap in the care of their patients.
Patients who frequent ambulance services and emergency department care often see large gaps in their medical records due to disparate PHI systems that don’t integrate from one facility to the next. Community paramedicine can help bridge that gap and improve the continuum of care.
Specifically, any patient who is seen by a first responder or EMT who utilizes telemedicine via RelyMD can have their visit information sent to their primary care provider with an easy to create, read-only record. The RelyMD physician includes any important details found during the visit, follow-on care instructions, and prescription information within that record. Additionally, if the physician has access to a patient’s current prescription list, they can act accordingly based on what the patient might have been seen for recently. This is especially helpful for patients who may have a chronic disease that requires frequent monitoring.
3- EMT and paramedics receive a boost in morale when they’re able to treat a patient instead of transferring when they know it’s not necessary.
Often EMT and paramedic teams are left with little other options when a patient requests a transfer to the local emergency department, even when it is a non-emergency. They aren’t trained or licensed to actually treat a patient on-site and it often leaves them with low morale. By allowing them to practice paramedicine, they’re able to more effectively help patients and save them a long trip to the local hospital by treating their injuries or illness. When pairing this with the ability to access an emergency medicine provider via video, the treatment they can provide expands even further. According to a recent case study released by RelyMD, Wake County EMS shared that the morale on their team did improve and that their team of emergency service providers were happy to be able to effectively treat patients while saving time and resources for patients who truly did need a transfer.
4- Pharmacies are able to help patients stay up-to-date on their meds via community paramedicine.
As described above, many times patients are calling on ambulance services because of their inability to follow post-discharge instructions, which can often be related to prescriptions or lack of refills. With the addition of telemedicine and community paramedicine, new prescriptions can be called in directly after a virtual visit that is facilitated by an EMT or paramedic. It no longer requires an in-person visit for a simple prescription refill.
Particularly with the older population and those with multiple prescriptions, when a prescription runs out they’re more often than not simply forgoing the prescription which leads to additional health issues- resulting in frequent 911 calls, especially when their transportation options are limited.
Not only does the patient reap the benefits, but local pharmacies are able to refill prescriptions more frequently and it helps keep the detailed questions from misinformed patients to a minimum.
5- Nursing homes and assisted living facilities benefit from ambulances equipped with direct access to emergency medicine providers.
Just like hospitals, nursing homes are on the hook (even more so starting in 2018) for hospital admissions of their residents and while having a telemedicine solution of their own could save them up to $2,518, on average, per transfer. Having their local ambulance trained for community paramedicine could benefit them as well.
Most of the nursing staff employed by a nursing home don’t come credentialed enough to provide care to their residents who have a more difficult illness or injury that needs to be treated. In addition, high costs of 24/7 physician support often leave facilities with limited access to physicians- typically only available during regular hours. This leaves residents with a higher risk of hospital transfer during after-hour periods when nurses can’t treat in-place and doctors aren’t available for a consultation.
With community paramedicine paired with RelyMD, ambulances that arrive for a potential transfer have the ability to contact an emergency provider to do a virtual consult with a patient who may have the option to stay in place with a specific care plan created by a board-certified physician until their regular doctor can be seen. Nursing home residents who can be cared for in place often fare better than those who must leave their area of comfort for higher levels of care by doctors they are unfamiliar with.
Community paramedicine has been put in place to better serve patients and to help improve the continuum of care. This added benefit has the ability to impact many different healthcare providers, not just the ambulance service alone. Instead of looking for grants to fund these services, the increased patient benefits and shared cost-savings across different facilities should be closely reviewed before writing off the big potential of this additional service due to lack of funding.
To learn more about how RelyMD is helping local North Carolina ambulance services, click here.
To learn more about how telemedicine has taken the emergency service by storm in recent years, click here.
June 19, 2017
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