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Paramedics Save the Day...and Then Some

This piece was originally featured in the Healthy Transitions Colorado July newsletter.

When asked to list types of primary care health care providers, the majority of people would probably say doctor or nurse. With prodding, perhaps pharmacists, public health providers, and medical assistants would come to mind. Paramedics and EMTs may not top the list, but Eagle County’s Community Paramedic program is starting to change people’s perceptions of paramedics.

Five years ago, most Americans in emergency medicine (much less the general public) had never heard of a Community Paramedic. The concept of training and utilizing paramedics to be an extension of the primary care provider was just emerging as a way to improve to care in rural areas. Determined to learn more, an EMS chief and public health nurse from Eagle County, Colorado, visited the closest program in existence, which at the time was in Nova Scotia, Canada.

Nova Scotia’s program was developed out of desperation. The one primary care provider on the small island of Brier departed the area unexpectedly, leaving residents hundreds of miles and a ferry ride away from primary care. Within three days, community paramedics were deployed to provide care – not in an emergency fashion – but to check in on the chronically ill and homebound to prevent the need for emergency care.

Eagle County isn’t as isolated as Brier Island, but they face similar challenges accessing health care. Primary care providers are in short supply across the United States in both rural and urban areas, and it’s only getting worse. To compound matters, Eagle County’s uninsured rate is 29 percent – 12 percent higher than Colorado as a whole – and only a handful of primary care providers in Eagle County will see uninsured patients.

There was no handbook for developing a Community Paramedic program when Eagle County started their program, but their results say they got it right. After three years of serving their community, they’ve saved the health care system a little over $412,000 by preventing ambulance transports and higher cost visits to the hospital, nursing home, physician offices and ER.

In partnership with Vail Valley Medical Center, the Community Paramedic program has contributed to reducing readmissions by 50 percent. Community Paramedics follow up with patients after they leave the hospital to make sure they understand their discharge instructions, are taking their medications properly, and connect them with a primary care provider when necessary.

Several fundamental principles were established prior to developing the Eagle County program which have been critical to the program’s success:

  • Community Paramedic services are based 100% on the needs of the community, and do not duplicate currently available services,
  • All Community Paramedic visits must be ordered and overseen by a physician to ensure high quality care, and
  • Engagement and support from community partners (providers, home health, hospitals, community leaders, etc.) is critical.

Eagle County’s program demonstrates the potential for EMS to fill gaps in care freeing up physicians and home health nurses to provide care at their skill level. Although there was no handbook or training curriculum prior to their program, both were developed by the Eagle County team and are now available free of charge at www.communityparamedic.org.

Thanks to Eagle County’s pioneering efforts, Colorado and other states are beginning to see new Community Paramedic programs popping up. With further expansion, EMS providers will become recognized as an essential and standard part of the primary care health care system.

For more information, watch the Eagle County Community Paramedic Webinar hosted by Healthy Transitions Colorado.

About the Author: Cari Frank is CIVHC's Director of Communications. Contact her at cfrank@civhc.org.

 

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