Community Paramedics: Here, There, (and soon) Everywhere

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Presentation transcript:

Community Paramedics: Here, There, (and soon) Everywhere National Rural EMS Conference May 5, 2015 Gary Wingrove, President The Paramedic Foundation

© 2014 The Paramedic Foundation. All rights reserved. National International EMT Primary Care Paramedic Advanced EMT Intermediate Care Paramedic Paramedic Advanced Care Paramedic (None) Critical Care Paramedic Community Paramedic Ambulance Service Paramedic Service © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. IRCP 2014 © 2014 The Paramedic Foundation. All rights reserved.

Special Recognition for Nevada Photo via Twitter - @Jaguargetaway © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. 208 Delegates 7 Countries Australia Canada England Ireland Norway United Arab Emirates United States © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. IRCP 2015 Hosted by the Council of Ambulance Authorities of Australasia (Australia, New Zealand, New Guinea) October 13 & 14, 2015 Melbourne, Victoria, Australia © 2014 The Paramedic Foundation. All rights reserved.

10 Years of International Collaboration Our Governments Are Investing © 2014 The Paramedic Foundation. All rights reserved.

Our Governments Are Investing 2012 United States - $13,500,000 Innovation Awards for CP Programs 2013 Australia – $4,000,000 CP Workforce Grants 2014 United States – $29,200,000 Innovation Awards for CP Programs Ontario – $6,000,000 Expansion of CP Programs Minnesota – $800,000 to one program for Shared Savings From Medicaid ACO © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. What’s In A Name? Community Paramedicine Most people “get it” with little explanation Largely rural Clinically integrated primary care teams Community Paramedic is a specific practitioner College course – v4 late 2015, international exam coming 3Q2015 Mobile Integrated Healthcare Requires explanation Largely urban Is a misnomer – the care isn’t mobile Administrative pathways, not clinical integration Variety of practitioners © 2014 The Paramedic Foundation. All rights reserved.

Paramedic Service Implications MIH – give a lot of staff a little training, be prepared for all 9-1-1 calls CP – give a few staff a lot of education, integrate into primary care © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. The Models – CP Primary Healthcare Substitution Community Coordination Blacker, N., Pearson, L., & Walker, T. (2009). Redesigning paramedic models of care to meet rural and remote community needs. The 10th National Rural Health Conference, Cairns, Australia, May 17-20, 2009. (Accessed via http://10thnrhc.ruralhealth.org.au/papers/docs/Blacker_Natalie_D4.pdf on November 30, 2011). © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. CP Example Minneapolis – ACO Primary Care team Community Paramedic immersion In home assessments, medication verification Lab tests, scheduled treatments Consultation with Primary Care Provider Implements altered care plan Schedules ancillary services Integrated IT system © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. The Models - MIH Administrative integration Referral pathways 9-1-1 nurse phone triage, referral Transport to “alternative destinations” Assessment with reporting findings to PCP May include CP (NP, PA, CHW) component © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. MIH Example Reno – Blended Program (CMMI funded) Create new care and referral pathways (MIH) Administrative integration Post-discharge in-home follow-up care (CP) Primary care integrated, Reduce readmissions Nurse Health Line (MIH) Administrative referral Community Health Paramedics transition of care (CP) Care plan education and follow up Ambulance Transport Alternatives (MIH) Administrative transportation destination pathway © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. How CP Grew Up 1990s – New Mexico, North Carolina 2005 – IRCP Curriculum 2007 v1 (Minnesota – CHW Roots) 2009 v2 (Colorado) 2012 v3 (35 colleges) 2014 – estimate 1,000 CPs nationwide, 400 at HTC alone 2015 v4, Int’l Exam 2015 – CPT Curriculum Pending © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. The Curricula Original CP Course 12 – 14 college credits Primary care integration V4 – 2015 Exam - 2015 © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. Out With the Old and …. © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. … In With the New © 2014 The Paramedic Foundation. All rights reserved.

Community Paramedic Technician 4 college credits 9-1-1 centered Treat/no transport Treat/refer Treat/alternative destination Assess & Report © 2014 The Paramedic Foundation. All rights reserved.

Community Paramedic Clinician 14-16 college credits Version 4 2015 Exam 2015 Primary care integration model © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. And In Reserve… © 2014 The Paramedic Foundation. All rights reserved.

Community Paramedic Practitioner Only delivered as part of a bachelor’s degree program Available date???? © 2014 The Paramedic Foundation. All rights reserved.

© 2014 The Paramedic Foundation. All rights reserved. Where We’re Headed International Registry of community paramedicine and MIH Programs International Registry of CPTs and CPCs CPT and CPC CE online and time zone conferences © 2014 The Paramedic Foundation. All rights reserved.

Questions? Gary Wingrove The Paramedic Foundation 2800 N. 7th Street St. Cloud, MN 56303 wingrove@paramedicfoundation.org wingrove.gary@mayo.edu Questions? © 2014 The Paramedic Foundation. All rights reserved.