Community Paramedicine Program The Future of Rural Health Care Presented by Jared Oscarson, NREMT-P Captain EMS Clinical Services Oscarsonj@hghospital.ws Louis Mendiola, B.S., EMT-II Community Wellness Coordinator Lmendiola@hghospital.ws
Community Paramedicine IS NOT A replacement for nurses or other health care workers. Another new project to divert money from hospitals, clinics and home health agencies. H-2 Change in the scope of pracbce for any provider
What is Community Paramedicine? The use of Community Paramedics in a nontraditional manner within the community in an effort to connect underutilized resources to underserved populations. H-3 Community Paramedics have an expanded role not an expanded scope.
What is Community Paramedicine? H-4
What Community Paramedicine Can Offer Rural Residents H-5 Health & Wellness Programs Health Screening Health Education Immunizations Monitoring of Diabetic Patients Monitoring of Post-MI Patients Access to healthcare options Risk Assessments
Why Community Paramedics? H-6 Paramedics Have the skills and knowledge to deliver quality care. Know how to assess resources and make critical decisions. Can fill the gaps in care with expanded skills and education. Seen as an approachable pillar of the community.
Issues Facing Nevada s Health Care System H-7 Shortage of Health Professionals A recent study completed by the Nevada Legislative Counsel Bureau Found That Nevada had the following rankings: 47 th Among the states: In the number of physicians per 100,000 population In the number of social workers 50 th in the number of nurses per 100,000
Issues Facing Nevada s Health Care System H-8 Uninsured residents Rapid population growth Low Medicaid coverage Low health status Behavioral health issues Large number of additional health services consumers as a result of PPACA 2010. Current EMS model requires transport
Rural Issues People in rural areas face many different health issues and disparities than people who live in urban areas. H-9 Access to health care Inability to travel long distances for routine checkups and screenings
Opportunities H-10 Provide cost effective health navigation to high utilizers of EMS and health systems. Can provide health services to low acuity visits. The eyes and ears of the physicians : Vital Signs Blood draws Oxygen saturation checks Wound checks Ear checks
Opportunities H-11 Moving away from the emergency only mentality, moving towards a proactive approach to community health and wellness. Assist patients that do not qualify for Home Health Services or Hospice receive episodic care in the patient s residence. Visits by Community Paramedics can help patients gain a better understanding regarding the importance of correct evidence based disease management. (CHF, Asthma, Pneumonia, MI, and etc) Assist with larger health promotion and wellness activities.
Opportunities H-12 Provide patients the ability to link with available community resources and other medical services. Community Paramedics are seen as an approachable community pillar that has the ability to meet the health needs of their fellow community members. Provide preventative services: In home flu shots Home safety and fall assessments
Opportunities Assure that the patients have the ability to properly follow up after a hospital discharge. H-13 Improve the patients willingness to properly follow up with a PCP or specialty physician. Provide the patient the ability to ask questions and get answers relating to their condition. Revisit and provide additional explanation on hospital discharge instructions.
Positive Benefits of a Community Paramedicine Program Reducing the volume of 911 calls Patients benefit from receiving medical care without having to call 911 H-14 Reducing Emergency Department visits Decreased non-critical patient transports Improve field screening capabilities Referring patients to the appropriate facility. Reducing healthcare costs
Positive Benefits of a Community Paramedicine Program Reducing hospitalizations Reduction hospitalizations costs H-15 Decrease hospital readmissions a paramount goal of the Patient Protection and Affordable Care Act of 2010. Promoting health and wellness Reducing the demand on long-term care beds Providing patients the opportunity to stay at home longer Patients stay healthier
Positive Benefits of a Community Paramedicine Program H-16 A team approach Medical Home/ACO Greater opportunity for EMS to become an integrated part of the healthcare continuum. Physician led quality assurance will be monitored by a physician medical director. Economic efficiencies in the overall healthcare system EMS may be more cost effective Decrease costs
How it Works 1. Identification of a patient that could benefit from the program 2. Referral from PCP H-17 3. CP coordinator contacts the patient to schedule a visit 4. CP provides services in the home that are within current scope of practice 5. CP will communicate with PCP to ensure quality of care and appropriate oversight 6. CP refers patient to appropriate facility, program, or other resource.
Current Trends H-18 A number of states have enacted legislation supporting Community Paramedicine. Locally: REMSA was awarded a 10 million dollar CMS grant to study Community Paramedicine in a more urban center. Programs are being developed throughout the country and globally.
Summary H-19 1. Nevada faces many health disparities, these disparities are worse in Nevada s rural, remote, frontier, inner-city and other traditionally underserved areas. 2. Community Paramedics currently holds skills that can help spread health care services in these underserved areas. 3. Provide a plethora of low acuity health services in a new and cost effective manner, in a setting welcomed by at risk patients. 4. Community Paramedics have the ability to deliver cost effective solutions to America s and Nevada s health care challenges. 5. AB 361 is important in proliferating these types of programs to a greater number of Nevadans.
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Community Paramedicine Program H-21 H-21 The Future of Rural Health Care Presented by Jared Oscarson, NREMT-P Captain EMS Clinical Services Oscarsonj@hghospital.ws Louis Mendiola, B.S., EMT-II Community Wellness Coordinator Lmendiola@hghospital.ws