Ramiro Jervis, MD, SFHM NSLIJ Advanced Illness Management ©AAHCM.
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Transcript of Ramiro Jervis, MD, SFHM NSLIJ Advanced Illness Management ©AAHCM.
©AAHCM
Community Paramedicine
Ramiro Jervis, MD, SFHM
NSLIJ Advanced Illness Management
©AAHCM
None
Financial Disclosures
©AAHCM
Clinical Scenario
©AAHCM
Why Community Paramedicine?
©AAHCM
Off hour & urgent in person assessments limited
Telephone assessments limited
Limits of Primary Care Models
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Why Community Paramedicine?
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Only 1 RCT: 27% ED use
Programs varied in implementation
Scattered reports of programs in the United States◦~40% utilization
Evidence of Success is Limited
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©AAHCM
Kashif Baqai BS, CCEMT-PDavid Kugler, MD
Elizabeth Quellhorst BFA, NREMT-P, CCEMT-P, PNCCT, CMTE, EMD-Q
Jon. D. Washko, BS-EMSA, NREMT-P, AEMDThomas Kwiatkowski MD, FACEP
Kristofer Smith, MD
Collaborative Effort
House Calls Providers credentialed as On Line Medical Control (OLMC)
NS LIJ Community ParamedicineExperience
©AAHCM
House Calls Providers credentialed as On Line Medical Control (OLMC)
NS LIJ Community ParamedicineExperience
©AAHCM
©AAHCM
Patient Education
Advanced Care Paramedics
Supplemental Instruction◦Geriatric assessment◦Advance Care Planning◦Clinical Rotation
NS LIJ Community ParamedicineExperience
©AAHCM
Community Paramedic Response
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Shortness of breath~47%
Change in mental status ~23%
Other ~30%
Community Paramedic Calls
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©AAHCM
Since October 2013◦1158 calls routed through EMS Call Center
◦120 Community Paramedic responses
◦23 transports to ED (19%)
Low Transport Rate
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Admissions avoided
Chart review of 42 Community Paramedicine
Responses
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Room For Improvement
Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 20140
50
100
150
200
250
14% 13%17%
13%19%
911 vs Call Center Initiated Transport
©AAHCM
Thank You