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Paramedics take on bigger role in community

Paramedics take on bigger role in community

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SUMNER - The concept is nothing new in some parts of the country.

Paramedics, who once only served their communities in emergency situations, are beginning to take a more proactive role. Some offer education services and make house calls in an effort to cut down on doctor and emergency room visits.

"In the U.S., Minnesota and Colorado kind of ran lead with this. Both of them started a pilot program within the last few years. You take a resource that is available in most communities and is largely an untapped resource and you put it to work to fill the gaps that exist in the health care system," said Brian Donaldson, director of Sumner Emergency Medical Services. "We are lucky here that our physician medical director saw that it would be a benefit to the community to have our paramedics expand their role to include some wellness and safety functions."

And that is phase one of the agency's community paramedicine program.

During the first year the group will begin doing mobile health and wellness screenings like blood pressure, blood glucose and gait and balance checks for the elderly; mobile immunization clinics; body mass index screenings; car seat and bike helmet clinics; and home safety assessments for the elderly.

"The key thing about community paramedicine ... It's not intended to compete with any of the other health care entities. It is actually intended to fill the gap and augment those services that are already available. There is room for everybody. We just want to make the system work better and I think everyone would agree that our health care is in need of some fine tuning."

Larry Nilges, the Sumner Emergency Medical Services board president, said the board has let the group run with this program.

"We are trying to be proactive and aggressive. Our crew, leaders and director are very energetic. They are on top of things. If there is something new out there they are willing to try it," Nilges said.

Two Sumner paramedic specialists, Donaldson and Susan Leary, are in the middle of a clinical rotation in family practice with Dr. Mary Pat Rosman, the agency's physician medical director. Donaldson said the hours logged in the office allow the paramedics to refine their skills and gives Rosman a chance to observe.

"They are working and shadowing me as I see patients throughout the day. They need to see the normal and nonurgent stuff, stuff they don't see while on an ambulance call because they are trained in emergency medicine," Rosman said. "This gets them some hands-on experience so they can better recognize these things the things we treat in the office when they are in the field."

The duo also will complete an instructional piece before they begin making house calls, likely in 2013. Rosman, who will refer patients to the paramedicine team, said there is a need in the community for the services they are preparing to provide.

"Years ago people could stop by the hospital and get their blood pressure checked," she said. "Now, that same person would have to be seen in the emergency room."

She said the in-home services will also help those who don't qualify for traditional home health services or have already used their allotted home health service for the week but need additional care.

Christopher Montera, chief in the Western Eagle County Health Service District in Colorado, said the program is taking off quickly in his community.

The agency has treated patients through an official community paramedicine program since June, though they have been laying the groundwork since October 2008.

"We helped an almost homeless man who was having some medical issues to boot," Montera said. "When our community paramedic went to see him he brought someone who could help the man with a Medicaid application, help him at the food bank and Salvation Army, and even get him into alcohol rehab. Now this gentleman is an active member of society. He called the office recently and said he just needed someone to reach out."

The agency also visits another patient weekly to help him remember to fill his pill box correctly. They talk to him, check his blood pressure and make sure he is generally doing alright.

"We are just trying to do the best thing for the patient at the lowest cost we can," Montera said. "Research has shown that people do the best when they are in their own homes. We are just trying to fill those gaps."

Donaldson, who worked with Montera before the community paramedicine program was implemented, also started a similar program in North Platte, Neb., where the service covered more than 2,000 square miles out of one station and served a population of just over 2,000 people.

"There was one physician for the entire service area. County public health didn't exist and home health was extremely limited," Donaldson said. "We did a lot of screenings and it worked out really good."

Montera said these kinds of programs will likely become increasingly prevalent in service areas like North Platte and Western Eagle County, where the paramedics serve an 1,100-square-mile area that requires two 24-hour paramedic units but have only 1,200 calls a year.

"Everyone keeps telling me we are changing the industry and I guess we kind of are," Montera said. "We are getting these paramedics out of the station and getting them into the community. We want to be a bigger part of the health care system."


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