Community Based Paramedicine: can it fill the medical gap?

With construction of the new Riverside Shore Memorial Hospital in Onley on schedule to open this time next year, the reality of the hospital moving north to Melfa is starting to sink in. While Northampton Supervisor Granville Hogg and the AD-HOC Emergency Care Committee grapple with how to adjust to this new reality, the use of community based paramedicine has not been discussed as an option for the lower shore.

Community paramedicine (CP) is a new model of community-based health care that leverages paramedics, using them in ways outside their customary emergency response and transport roles. Community paramedicine attempts to posit a model that more efficiently uses emergency care resources while enhancing medical access for typically underserved populations like the lower eastern shore. These programs usually use existing relationships and collaborations between EMS and other health care and social service providers. Where community paramedicine may help our community, is that it may improve access to, as well as the quality of care while also reducing costs.

Another issue that paramedicine addresses is the chronic overuse of the 911 system for social or psychological problems, using EMS as a de-facto taxi service to medical facilities. Community paramedicine also provides an alternative means to manage patients who do not require transport to the emergency room, limits repeat ED visiting or hospital readmissions due to gaps in care between hospital and outpatient primary care or specialty management, and supplementing primary care shortages in underserved areas.

The important point here is that community Paramedicine fills healthcare service gaps, without replacing healthcare workers. It focuses on providing services where access to care is limited, or a short term intervention is needed. By targeting locally identified health care needs, offering a creative solution to fill local health care gaps – community paramedicine helps to increase access to care, and often reduces health care costs by providing the right level of care based on the individual’s medical needs.

Community Paramedics are not out there working all alone, but instead operate under clear medical control of a physician, receiving direction and supervision to ensure patient safety. It doesn’t require sophisticated technology or telemedicine, but instructions and communication can take place using just a telephone. The Ad-Hoc Emergency Care Committee Community hopes to use state and federal grants to bring military medics and corpsman who transitioning out of the military to work on the shore. These are the perfect candidates for paramedic training programs which builds upon the training and skill sets of experienced paramedics. Additional training in patient assessment, clinical skills and familiarity with the other healthcare providers and social services available in a local community will all be a part of the required training, and will lead to a more integrated and sustainable approach to health care delivery.

Community based paramedicine is based on paramedic theory which is the study and analysis of how the three pillars of paramedicine (health care/medicine, public health, and public safety) interact and intersect. More emphasis is needed in the integration of emergency medical services,emergency response, response planning, community education, transport medicine, disaster preparedness/response, emergency management, pandemic and epidemic, emergency response planning, special operations, medical aspects of rescue.
Given the gaps we are soon about to be facing, now would be the time to begin implementing a plan that would provide medical coverage for folks on this end of the shore. Community based paramedicine is not the only answer, but it should be a major part of an integrated approach to filling the medical needs of Northampton County.