Community Paramedicine: Next Step in HealthCare

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By Staff Reports

(Victor Valley)– San Bernardino County Fire is honored and excited to be a participant in a statewide pilot project that will study the value of Community Paramedicine (CP).

“Community Paramedicine is the next innovative wave in healthcare,” stated Fire Chief Mark Hartwig. “The goal of this program is to augment the patient’s current plan of care with resources currently established within the community, which will provide the patient with the necessary education and tools to maintain and improve wellness outside the hospital setting.”

San Bernardino County is one of twelve locations chosen to participate in this 12-18 month pilot program to study various aspects of CP. County Fire has been awarded the opportunity to study post discharge follow-up of the congestive heart failure (CHF) patient. In this study, we will partner with Rialto Fire Department, San Bernardino County Department of Public Health, Arrowhead Regional Medical Center and the Inland Counties Emergency Medical Agency (ICEMA) to provide a post discharge follow-up visit to the patient’s home in order to perform a detailed physical assessment on the patient and ensure the patient is maintaining or improving their post hospital discharge status. During the follow-up visit, the community paramedic will also verify the patient’s understanding of their disease process, discharge medications and follow-up plan. Should the patient require further medical treatment, the community paramedic will assist the patient in accessing primary care or fulfilling their healthcare need.

Today San Bernardino County Fire Training, Special Operations & EMS Section kicked off the training of seventeen firefighter paramedics (10 from SBCoFire, 5 from Rialto Fire, 1 from Fountain Valley Fire & 1 from Huntington Beach Fire) for this groundbreaking and innovative healthcare model.

What is Mobile Integrated Healthcare (MIH) and Community Paramedicine? 

In short, MIH is the provision of health care using patient-centered, mobile resources in the out-of-hospital environment. Since the creation of modern emergency medical services, EMS has largely been considered a transportation system for people suffering a medical or trauma related healthcare emergency.  However, recent changes in healthcare have created an opportunity for EMS to evolve from a transportation service to a fully integrated component of our nation’s healthcare system.  EMS is uniquely situated within the communities and with the proper medical oversight can efficiently and effectively direct patients to the right care, in the right setting at the right time.

Community Paramedicine is one aspect of MIH in which paramedics function outside their customary emergency response and transport roles in ways that facilitate more appropriate use of emergency care resources and/or enhances access to primary care for medically underserved populations.

The focus is on providing services, where access to care is limited, or a short term medical intervention is needed. CP programs are typically designed to address specific local problems and therefore vary in nature. Interest in CP has grown substantially in recent years based on the belief that by targeting locally identified health care needs, and offering a creative solution to fill local health care gaps, CP helps to increase access to care, and often reduces health care costs by providing the right level of care based on the individual’s medical needs.

Community Paramedics will complete 160-plus hours of classroom training and clinical work; to include detailed CHF patient assessment, medication reconciliation, laboratory valuations, home safety inspections, as well as learning of community resources and more.

The program is expected to begin by the middle of this year, with San Bernardino County Fire Community Paramedics testing the program in Fontana, Hesperia and Victorville.  The goal is to reach out to CHF patients within the first 48-72 hours of being released from Arrowhead Regional Medical Center.

San Bernardino County is home to one of the largest per capita populations of congestive heart failure (CHF) patients in the U.S. Sufferers of this condition who either poorly or mismanage their disease depend on the emergency medical system (both 911and hospital emergency departments) to keep their condition in check. Through these interventions, we hope to decrease the rate of re-admission to the hospital, the necessity to access 911 for non-emergency situations, and ultimately improve the quality of life for this patient population.

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