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Community paramedicine in value-based care



Paramedics on bicycles in Los Angeles.

Kenneth W. Kizer, M.D.,  is an expert on the expanding potential of community paramedicine. As a former director of the California Emergency Medical Services Authority, he wrote the regulations for paramedicine in the state.  More recently, he has become a  thought leader in population health — and an advocate for community paramedicine in value-based care.

Hospitals & Health Networks recently interviewed him.

Among his remarks:

“Community paramedicine is an important component of population health management and the new emerging value-based health care economy because it fills gaps in the typical health care delivery infrastructure that are especially relevant to value-based payment.

“The focus of CP programs varies widely — from paramedics providing directly observed treatment for tuberculosis patients at their homes to providing transportation to health care facilities other than emergency departments and many other concepts.”

“The programs that respond to the 9-1-1 superusers hold a lot of promise for better utilizing scarce emergency care resources, including ambulances and hospital emergency departments. We know that in many communities some people call 9-1-1 multiple times per week when what they really need is help with basic primary care or other support services. Many of these persons may be homeless or have mental health needs or other problems that are not always better managed in the ED.”

“Another type of program that I think is going to prove to be very helpful is one that provides follow-up care after a hospital discharge or an ED discharge. These programs serve patients before they can get in to see their usual provider or — probably more often — until they can establish a relationship with a regular health care provider.”

To read the whole interview, please hit this link.


Paramedics take on powerful preventive role



Bicycle paramedics in Los Angeles.

The Wall Street Journal reports that a new initiative called community paramedicine is training “the fast responders in chronic disease management, medication compliance and home safety. Paramedics are …{being} sent on scheduled house calls to frail and elderly patients or those who have trouble managing chronic conditions like heart failure and diabetes.

“Community paramedics take vital signs, administer IV medications, and perform lab tests as well as help patients understand follow-up instructions after being discharged from a hospital. They check for risks such as where patients could fall in their homes and whether they understand their medical regimens. They also work with doctors, nurses, dietitians and physical therapists to coordinate future care.

“In this new role, paramedics augment existing programs like visiting nurse services and home care. They also treat patients who don’t meet home-nursing criteria or don’t want someone in their home all the time but still have complex needs, says David Schoenwetter, an emergency physician and head of the mobile health paramedic pilot program at Geisinger Wyoming Valley Medical Center in Wilkes-Barre, Pa…..”


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