Community Paramedicine:

1. Community Paramedicine: An Emerging Model of Care for Rural and Underserved Populations

2. An Evolution of EMS • Traditionally EMS supports an emergent system of care for communities. • Paramedics are highly skilled and trained to deliver a wide range of medical services to those in need. • A new model of care is currently being deployed on a national scale to broaden the services available for patients in rural and medically underserved communities.

3. Communities and Patients in Need: • For nearly 75 million people living in rural areas of the United States, health care needs far outnumber health care options. These communities already include disproportionate numbers of elderly citizens, immigrants, impoverished families and those in poor health.

4. Community Paramedicine “It’s a simple concept: Connect underutilized resources to underserved populations. In this case, we’re expanding the roles of EMS workers to provide health services where access to physicians, clinics and/or hospitals is difficult or may not exist.”   Gary Wingrove, Project Director Community Healthcare Emergency Cooperative http://chec.ncemsi.org/

5. Community Paramedicine

6. Case Study: A Familiar Address • The paramedics’ radio blares a familiar address: that of 71-year-old Dorothy, who knows each of the paramedics by their first name. A widow who lives at the rural home she and her late husband built, she cares for herself as best she can but often loses track of her medication regimen or misses medical appointments. They know all too well the results of her struggle with a fixed income and reluctance to ask one of her daughters to take time off work to take her to see her physician or refill her prescriptions. Often, she doesn’t notice the swelling in her legs or pallor of her skin until she’s already fighting to breathe.

7. Case Study: “Outside the Box” Care • “I’m not going!” he says from the hospital bed in his living room. His wife smiles and replies, “Today, you don’t have to.” Paul, who is receiving care for a stubborn diabetic ulcer that just won’t seem to heal, is greeted by a paramedic with a video camera and tablet computer. After capturing and sending off high-definition video of the wound, the paramedic places a new dressing as the smiling face of Paul’s physician appears on the screen to discuss the current care plan.

8. Community Paramedicine • Possible Partnerships with: • Public Health Departments • Physician Practices • Hospitals • Other Health Care Providers • Program Goals: • Reduce Readmissions • Reduce 911 calls for non-transport • Reduce 911 calls for non-emergent (frequent callers) • (Community Paramedicine, 2010)

9. History • Counties Served • Current Services • Rural Service Regions • Values: creativity, fostering innovation through partnerships and affiliations.

10. Future Opportunities • Develop Academic Partnerships to Meet Curricular-Based Needs. • Investigate Alignment with Community Service Needs. • Establish Research Partnerships to Determine Programmatic Effectiveness Across the Care Continuum. • Establish Rural Partnership Alliances in Indiana

11. Challenges and Barriers • Reimbursement • Demographics/Logistics • Care Coordination Strategies • Communication

13. THANK YOU