Do you know the Emergency Medical Services chief in your community? Do you have his or her cell phone number, talk regularly, or meet for lunch on occasion?
I asked Anne Robinson, public health nurse consultant to Eagle County, Colo., whether most hospital executives in her community know their EMS chief or administrator.
"I would say they know them by name, but do they really know them and understand what EMS is? I would say no," she replied.
The time has come to get to know them. They might just be the missing link in the medical home and in creating a truly integrated healthcare community.
"The people that are bringing you patients every day, into your doors, have a direct impact on what happens when they enter your doors," Christopher Montera, chief of the Colorado's Western Eagle County Ambulance District (WECAD), said in an interview. "As a CEO it can be impactful to invite those people to the table."
Montera and Robinson are at the helm of a community paramedic pilot program between Eagle County Colorado's public health department and WECAD. In the community paramedic model, patients are referred to EMS personnel by their primary care physician to receive services in the home, such as hospital discharge follow-up, blood draws, medication reconciliation, and wound care.
In addition to the county and WECAD, local hospitals and medical centers are onboard with the pilot. Colorado Mountain Medical, Eagle Care, Eagle Valley Medical Center, Vail Valley Medical Center, and Valley View Hospitals' primary care physicians are referring patients within the WECAD district, which encompasses 1,100 square miles in western Eagle County and eastern Garfield County.
"The program is about utilizing paramedics in an expanded role in the community," Montera said. "It's not paramedics going out and doing suturing or writing prescriptions…it's utilizing paramedics within their scope of practice," and letting them "be the eyes and the ears of the physician in the home."
For Robinson, EMS represents an "untapped area of healthcare" that can help hospitals, providers, and communities reduce costs and keep patients healthier by following up in the home, preventing complications, and reducing readmissions.
"EMS is part of healthcare but not really," she said. "I don't think that healthcare in general has embraced or understands what EMS professionals can bring to the table."
Because of this lack of understanding, Robinson and Montera said they've been working to educate and get buy-in from hospital executives, because their enthusiasm will have a ripple effect on stakeholders throughout their organization.
"Our hospital CEOs understood that they needed to engage the EMS community in a different way than they ever had before," Montera said. "I think that they're really onboard with the concept and have really embraced the program."
In addition to education, Montera and Robinson are also asking hospital CEOs what they wanted the pilot to achieve.
"One thing that they wanted to measure was the number of times a patient was impacting or contacting the system," Robinson said. For example, how often was a patient in the urgent care, in the ED, or hospitalized during a given amount of time and did engaging with community paramedics change that?
Are readmissions dropping? Do patients understand their medications? According a New York Times article, a community paramedic program in Texas helped cut more than 1,000 911 calls per year to the EMS MedStar.
With stats like that in mind, Montera said they've built into the pilot an evaluation tool to collect data and prove that the program saves money.
Whether the EMS in your community is paid or volunteer, or whether you plan on implementing a community paramedic program doesn't matter; Montera said hospital CEOs should reach out to them anyway.
"Invite them to the table to start talking about their issues, because their issues are equally as important as those in the hospital, and I bet oftentimes you'll find that those issues are probably the same," he said. "Impacting healthcare in the community happens across many spectrums, and if we're going to be leaders, we need to act like leaders, and pick up the phone and talk to each other."
Alexandra Wilson Pecci is an editor for HealthLeaders.
