Community paramedicine: how EMS can work smarter, not harder

Since the Affordable Care Act was signed into law in 2010, health care providers at all levels have been scrambling to become more effective in providing patient care services. Agencies have been exploring the effectiveness of programs like discharge care, clinic staffing, alternative destination guidelines and the better management of psychiatric patients.

EMS, in particular, has been in the forefront of the sea change that is happening to the healthcare landscape. An increasing number of communities have taken their tentative first steps into community paramedicine. Unfortunately, these initiatives — noble as their intentions might be — serve only a limited number of the population. The existence of these programs highlights deeper problems created by a broken and fragmented health care system that is not yet able to provide the myriad of services that are desperately needed.

One elderly couple has called their local 911 provider every day for three years to help them get out of bed. A Florida system is grappling with a small population of patients that take up a disproportionate amount of resources. Minnesota EMS providers drive hundreds of miles in order to transfer psychiatric patients to an appropriate facility. Each of these examples is a sign of a health care system that is unable to provide a safety net that makes any financial sense.

Our country spends more money per citizen on health care than any other country in the world, yet we are not ranked number one in any measurement of health care outcome. We die sooner than citizens of other industrialized countries. Our rates of obesity, infant mortality and chronic medical conditions are higher. Ironically, while we spend far more on health care than anyone else, we actually have less access to physicians. Much of the money is used to fund prescription medications, costly testing and expensive technology — which can solve specific problems, but do little to improve our nation's overall health and levels of chronic illness.

These sobering facts makes innovative projects such as community paramedicine and mobile integrated health that much more important than they might seem at first glance. Most of the current projects take low-cost, common sense approaches to fixing large scale problems by helping patients on a personal level and linking them to more appropriate care.

If more funding and attention is given to projects like community paramedicine, our nation's health care system could work more efficiently, spend money more effectively and most importantly improve patient outcomes. It is for these reasons that we must continue to push for progress on this front. As we evolve our roles away from traditional standalone emergency services, we stand poised to help create a better care system for all.

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