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babhits16

Community EMS Summit

4 posts in this topic

Bellerose Rescue, a volunteer ambulance agency located in Queens,is hosting a Community EMS Summit.  The goal of the event is to expose small agencies and EMS providers to the future of EMS in regards to community paramedicine and mobile integrated healthcare.  I think this would be a great opportunity for some Westchester agencies to look at how they can provide better service to their patients, without having to transport every patient to the ER (aka treat and release).  Funding of such programs will be discussed. 

 

If anybody has any questions they should email Dan at Dan@NYCommunityParamedicine.org .  I really think this would be a great opportunity for Westchester EMS agencies to expose themselves to some new viewpoints on how they can better serve their residents and increase EMS value.

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Edited by babhits16
ARI1220 likes this

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This looks like something interesting. I am sure it will answer many questions, but three that I wonder about first is will protocols allow this sort of treat and release practice? Will a priority dispatch system be part of this so the calls not requiring urgent care be identified and allocated the correct resources? Finally will the hospitals, which are all profit making entities as well as healthcare providers ever support a VEMS unit going out and providing free care that does not lead to a transport and E/R visit?

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1 hour ago, AFS1970 said:

This looks like something interesting. I am sure it will answer many questions, but three that I wonder about first is will protocols allow this sort of treat and release practice? Will a priority dispatch system be part of this so the calls not requiring urgent care be identified and allocated the correct resources? Finally will the hospitals, which are all profit making entities as well as healthcare providers ever support a VEMS unit going out and providing free care that does not lead to a transport and E/R visit?

 

The summit will answer a lot of your questions and provide real examples but in the event you can't make it I'll explain a little here.

 

First off, in NYS (and I suspect this is applicable to other areas as well)  there is nothing that cannot be done via on line medical control orders.  What the OLMC physician says goes.  He can make discretionary orders outside of protocol treatments as he pleases.  After a treatment has been given and feels comfortable with the patients condition he can accept a transport refusal (not a treatment, just a transport).  This process is getting even better with the introduction of telemedicine.

 

Going out of order to the funding issue- at this point in time community paramedic programs are not very generalized to 911.  They are more for handling specific diseases or patient populations.  A program is of little benefit if it is not linked to a healthcare system or other sort of healthcare provider.  The most common programs revolve around the 30 day readmission policy.  Under the Affordable Care Act, hospitals are not compensated for care of a patient if that patient is readmitted within 30 days of the original admission.  Therefore, there is a strong incentive to invest a little bit of money to keep those patients home, out of the hospital.  What is happening is that hospitals are identifying 'flequent flyers' or diseases that cause the most admissions and assigning community paramedics to help follow them and treat at home if possible.  The money spent on CP services is miniscule compared to the savings it creates.  So to answer your question, yes- hospitals want to keep patients home.

 

The problem with EMS, particularly in NY, is that treatment and transport are linked together in terms of reimbursement.  We need to advocate for the disalignment of treatment and transport so that they are two separate things.  If that were to happen EMS could begin to bill for the treatment alone, providing a revenue source for CP visits.  Some states such as Minnesota, Califnornia and Pennsylvania are beginning to do this.  Once this occurs I can absolutely see omega and certain alpha level calls being treated at the CP level (aka treat, coordinate care and release).  But until that revenue model is there, CP will not regularly be a part of 911.  However, tax based municipal agencies that cannot bill are beginning to see the benefit of this to prevent frequent flyer usage of emergency ambulances.  Hospital/ healthcare and municipal/ FD based are two totally separate animals.

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Sounds like a good idea.

Edited by bfd1144

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