Community Paramedicine: the Hennepin EMS pilot

1. Doug Gesme, MBA, EMT-P Dave Johnson, CP, CCEMT-P Community Paramedicine: the Hennepin EMS pilot

2. Our program at present • One Community Paramedic • M-F 0700-1600ish • 15 Current regular clients • 20 clients is goals load • Ages 7 to 105 • ~50 total client interacted with • Ideal and Actual clients are often different

3. Target Population • Chronic, Non-Transmittable Disease • Cardiovascular, Diabetes • Most have subordinate Chemical Dependency / Mental Health Issues • High-Risk for readmission or avoidable ER use • Ineligible/Unwilling/Inaccessible to Home Care RN/PHN

4. Identify your Players • Advanced Practice Providers • Innovative, Respected and ACCESSIBLE • Administration • Care Coordination groups • Healthcare Home, Clinical Coordinators, Case Managers, Discharge Planning

5. Our next steps • Executive Leadership Blessing • Completion of Clinicals for 12 students • 10 HTC, 2 Inver • May have three certified late January 2014 When EMS wants to do something, we do it. When the corporate world wants to do something, they have meetings about meetings. Patience!

6. Clinical Process • Hennepin Tech has quality offerings • Not a perfect match for HCMC’s program • Clinicals should be based on organizational needs • Great opportunity to identify needs • Clinicals are a great relationship building opportunity

7. Clinical Experience • HCMC • ER • Coordinated Care Center Clinic • Senior Care Clinic Home Visiting Program • Burn Center ICU • Medicine Clinic • Community Health Workers • Hennepin Co HSPHD • Healthcare for the Homeless • Project Homeless Connect • Minnesota Visiting Nurse Agency • Home Care • Hospice of the Twin Cities • Hospice of the Valley • St. Stephen’s Human Services • Street Outreach • Scott County PH • Mobile Free Clinic • Golden Valley Health/Rehab • Wound Care

8. Our Resources • VisiCADIntegration • “EMS-CP1” • PNC “EMS Scheduled Event” used • ARMER Radio Resources • “HC_BUS” for primary operations • HCMC IT Connection • Epic Department “HCMC COMM PARAMEDIC” • Sprint 4GLTE Connection • Cell Phone & Pager • iSTAT Point of Care (CHEM8, CG4+, PT/INR) • EMS Administrative Vehicle (Thanks Doug)

9. Our Learning Points • Relationships are Everything • Ensure you are not stepping on toes • Less Productive time is VERY Productive time • Understand your target population • Don’t try to re-invent to wheel • Share in and support existing success • Profit is a very funny word • ~3% reimbursement of our pittance • Cost Avoidance

10. Relationships Some are obvious • Primary Care • Home Care Agencies • Ambulatory Care Many are not • Laboratory • Pharmacy • EHR • Social Services • Food Shelf • Homeless Services • Interpreters • And on and on and…

11. MY Learning Points • You are not managed by dispatch. • Productivity is no longer UHU’s • Design your workload and manage it well • Work Life / Personal Life Balance • You will bring work and Progress Notes home with you • Your SO will get sick and tired • Client Access is key • Don’t let admissions bother you. They are inevitable.

12. Questions • David Johnson • david.johnson@hcmed.org • 612 396 6935 • Doug Gesme • douglas.gesme@hcmed.org • 612 393 5437