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Community paramedicine programs have been a hot topic among EMS leaders, but putting one together can be daunting. Recently the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Office of Rural Health Policy (ORHP), under contract with Strategic Partnerships, Inc., and the Critical Illness and Trauma Foundation, published the 2012 Community Paramedicine Evaluation Tool, a community paramedicine evaluation method, which is designed to provide a common evaluation framework for the growth and development of this emerging aspect in community healthcare.
According to Megan Meacham, MPH, public health analyst for the ORHP, the EMS professionals who gathered to develop the evaluation tool took a two-pronged approach.
For agencies considering launching a community paramedicine program, the tool can be used to help establish measurable outcomes, providing the framework for assembling not only evidence of cost-savings, but important health outcome data. It has the added benefit of providing a laundry list of the elements that must be considered when establishing a program.
For agencies with a program in place, the tool can be used to provide a benchmark for future evaluation, identifying areas of improvement, for example.“This is the first step in starting to think about evaluating a community paramedicine program in a standardized way,” Meacham says.
As several rural EMS groups began working on gathering lessons learned from the early adapters of community paramedic programs, the ORHP got involved to assist and provide funding for the evaluation tool. “Those discussions led into the broader discussions on ways to evaluate [the programs],” she says.
Meacham notes that federal funding mechanisms are increasingly moving toward evidence-based programs. The group recognized that to qualify for federal and state grant programs, agencies would need a standardize way to measure the community paramedicine programs and capture data. The resulting assessment tool contained in the 56-page document is designed to provide a common framework for collecting data, regardless of whether it is an urban or rural community paramedicine program. Although no grants specific to community paramedicine are offered through ORHP at this time, there are grant programs where community paramedicine-related activities may be acceptable projects.
One such program is the Rural Health Network Planning Grant, a one-year grant that provides funding to rural entities to lay the foundation for a rural health network. The grant program supports one year of planning to develop and assist health care networks in becoming operational. It is anticipated that application guidance for this grant program will be released in the summer of 2012.
The ORHP hopes the community paramedicine tool will be particularly valuable to EMS providers in rural areas, where it can be used as a planning process to help create important partnerships to maximize scarce resources. Regardless of the setting, the document recommends building community advisory committees to avoid situations where one group or another gets territorial. “It helps with the buy-in,” Meacham says.
To better understand the elements that led to the successes as well as the challenges of implementing a community paramedicine program, the group reviewed five programs that were developed in both rural and urban settings. These programs included Western Eagle County Ambulance District, in Vale, Colo; Emed Health, at the University of Pittsburgh, Pa.; Scott County, Minn.; San Francisco Fire Department’s Homeless Outreach and Medical Emergency (HOME) Team; and MedStar in Fort Worth, Texas. “That was our intent with putting this program out there—to learn from them,” Meacham says.
The ORHP coordinates activities related to rural health care within the U.S. Department of Health and Human Services. As part of the HRSA, ORHP has department-wide responsibility for analyzing the possible effects of policy on rural communities. Created by Section 711 of the Social Security Act, ORHP advises the Secretary on health issues of 62 million residents living in rural communities, including the effects of Medicare and Medicaid on rural citizens’ access to care, the viability of rural hospitals and the availability of physicians and other health professionals.
In 2010, President Obama introduced the Improving Rural Health Care Initiative with the objective of improving access to quality health care in rural areas by strengthening the regional and local partnerships among rural health care providers; improving recruitment and retention of health care professionals in rural areas and by providing direct health care services.
The Community Paramedicine Evaluation Tool can be found on the ORHP website at: www.hrsa.gov/ruralhealth. It has also been posted to the EMS Insider LinkedIn group at www.linkedin.com.