Community Paramedicine, or Mobile Integrated Healthcare, has been sweeping across the nation as a cost-effective way to treat chronic conditions, reduce hospital readmissions, reduce unnecessary 911 transports and better reach underserved segments of the population. It also makes good use of the medical training and skills of EMTs. As EMS agencies consider starting a MIH/CP program of their own, they are often faced with the question of how care is documented and what reporting will be needed. They may have several options before them, but which is best for their program?
Keep it patient-centric. In 911 call situations, medics are asked to make quick assessments – usually starting with very little to no information about the patient other than what they observe or what bystanders may have witnessed prior to unit arrival. In those cases the focus is on the evidence of the incident to stabilize and transport if necessary to the appropriate emergency department. The community paramedicine approach is entirely different. Patients can be selected based on criteria and enrolled into the program that will best serve their needs. The medic may need to access and consider current medications from various care providers or evaluate vitals over many visits. They will be able to take a proactive approach toward reducing risks such as trip hazards in the home or identify the patient’s support network. With this patient-centric approach to care, simple ePCR systems are ill-equipped to gather the data and make it easily accessible to the medic. A more specialized MIH/CP solution is needed.
Stay flexible. While specialized MIH/CP software can track patients in a different way than ePCR software, you’ll still want flexibility for new programs, new types of care or conditions, and other changes. A hard-coded, proprietary solution makes change difficult or costly. Look for a system that allows for the creation of new worksheets and forms as your agency’s or community’s needs change.
Share with other providers. A connected system can greatly reduce data entry, while making it easier for care providers to properly treat the patient. Your solution should allow for integrations with ePCR, HIE, hospital EMR and other relevant systems. Everything should be conducted with secure methods to protect sensitive patient data.
Use what works for you. Hospital-oriented solutions are not always a good fit for EMS-based care. ED and clinical documentation often are focused on inpatient treatment and not focused on the needs of in-house visits and home safety assessments. Use a system that is built for this situation. Generally, it is software that is similar to what medics use in the field for 911 calls, and is easier for them to use without learning new, complex technology.
Know your program. It might be easy to focus on the function in the field, but the success of a MIH/CP program will be demonstrated through empirical evidence. Powerful reporting allows you to examine the success factors of your program in addition to your patients’ progress toward their goals. Advanced reporting helps measure your impact and can gauge effectiveness in the Triple Aim: improving patient experience, improving the health of populations and reducing the per capita costs.