Population Considerations for Community Paramedicine Programs
Community paramedicine programs are frequently developed to serve specific patient populations; some of the most common are described below. In order to best invest available local resources, programs can be tailored depending on the needs of the specific community. These needs can be established using a community health assessment.
Frequent emergency medical service (EMS) utilizers. Programs work with frequent EMS utilizers to identify and address the root cause for their 911 calls. Information about call frequency can usually be found in a 911 call database or through the electronic health record system at the local hospital.
Some people who call EMS frequently do not always have an emergent medical issue. Instead, they may be without access to a primary care provider or have underlying conditions that cause distress, including social isolation. Often these needs can be better addressed by other community organizations. As part of the patient's care plan, the paramedic may connect them with non-emergency services, like mental health services, for more targeted support that addresses the patient's needs.
Post-discharge patients. Patients recently discharged from a hospital stay may need additional help understanding their post-discharge care plan and managing their health. Community paramedics can review the patient's discharge instructions and any new medications. They will also periodically check in with the patient. The goal is to identify challenges the patient is having with the transition back home so they can be addressed early, before the patient ends up back in the hospital. This type of program provides the patient with the resources to manage their health at home and mitigate the risk of hospital readmission.
For EMS agencies partnering with hospitals to implement their community paramedicine program, this population may be particularly important. Hospitals can in some cases receive a financial penalty if a patient is readmitted to the hospital within 30 days of discharge.
Patients with chronic conditions. Community paramedicine programs often serve patients with chronic conditions. Program leaders may use data from hospitals, EMS, or health departments to identify the subset of conditions that are most likely to affect patients in their service area. Populations frequently enrolled in community paramedicine programs include patients who experience:
- Congestive heart failure (CHF)
- Chronic obstructive pulmonary disease (COPD)
- Diabetes
- Fall risk/hip and joint issues
- Pneumonia
Some community paramedicine programs have developed or adapted home visiting care protocols to meet the needs of people with specific chronic conditions. These protocols frequently include education, vital signs screenings, and medication management. Programs can also provide patients with supplies or other durable medical equipment to help them better manage their health. For example, pharmaceutical companies may provide free glucose monitors, which the community paramedic can deliver to people with diabetes while offering information about how to properly use and care for the monitor.
By helping patients better manage their chronic conditions, community paramedics can ultimately reduce the need for hospitalizations.