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Community Paramedicine /Mobile Integrated Healthcare Survey Summary

Community Paramedicine /Mobile Integrated Healthcare Survey Summary. Prepared October 2013. What are Community Paramedicine (CP) & Mobile Integrated Healthcare (MIHC) Programs.

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Community Paramedicine /Mobile Integrated Healthcare Survey Summary

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  1. Community Paramedicine/Mobile Integrated HealthcareSurvey Summary Prepared October 2013

  2. What are Community Paramedicine (CP) & Mobile Integrated Healthcare (MIHC) Programs • CP/MIHC programs use EMS practitioners and other healthcare providers in an expanded role to increase patient access to primary and preventative care, within the medical home model. • CP/MIHC programs work to decrease the use of emergency departments, decrease healthcare costs,and increase improved patient outcomes. • The introduction of CP/MIHC programs within EMS agencies is a top trend in emergency medical care.

  3. Why the CP survey was conducted • To better understand the extent and characteristics of CP/MIHC programs across the country. • To have a basis for understanding the CP/MIHC trend – which helps all of us in EMS – so we can develop strategies and policies to support it.

  4. CP survey participation • NAEMT joined with 16 other national EMS organizations to collect information about CP/MIHCprograms.

  5. NAEMT thanks the Community Paramedicine Committee for survey development  • Committee Chair: Matt Zavadsky, NAEMT Director • Committee Members: • Rod Barrett, NAEMT Director • Dr. Jeff Beeson, American College of Emergency Physicians • Jim DeTienne, National Association of State EMS Officials • Dr. James Dunford, National Association of EMS Physicians • Troy Hagen, National EMS Management Association • Dr. Paul Hinchey, NAEMT Medical Director • Dr. Doug Kupas, National Association of EMS Physicians • Scott Matin, NAEMT Director • Connie Meyer, NAEMT Immediate Past President • David Newton, National Association of EMS Educators • Mark Rector, International Academies of Emergency Dispatch • Gary Wingrove, NAEMT Advocacy Committee

  6. Appreciation to CP survey contributors • Joint National EMS Leadership Forum – assisted with survey development and distribution to their individual members. • Aaron Reinert, Chair of the National EMS Advisory Council – assisted in analyzing the survey data. • Gary Wingrove, a member of NAEMT’s Community Paramedicine Committee – developed the online map of CP programs.

  7. Survey results at-a-glance • 3,781 total responses were received – primarily from EMS practitioners, EMS managers, medical directors, and CP/MIHC program administrators. • Total responses were evenly dispersed across all types of EMS delivery models. • Survey results identified 232 unique CP/MIHC programs (6% of responses). • 566 respondents (15%) indicated that their EMS agencies were in the process of developing a CP/MIHC program.

  8. Details of the CP survey summary • The summary presents information on the 232 CP/MIHC programs reported by respondents. • The summary reports only on responses received.Several respondents did not complete all of the questions in the survey. • On some questions, respondents were able to select more than one response, or didn’t select any, which caused the percentage total to not equal 100%.

  9. States reporting CP/MIHC programs in place Respondents from 44 states, plus the District of Columbia and Puerto Rico, reportedprograms. (One respondent, representing an ambulance company, indicated programs in multiple states.)

  10. Programs represented — all delivery models Private, for profit Volunteer Public, municipal Private,non-profit Public, hospital Public, fire-based Public,county or regional

  11. Population served by CP/MIHC programs

  12. Annual call volume of CP/MIHC programs

  13. Size of area served for CP/MIHC programs

  14. Population density of CP/MIHC programs

  15. Catalyst for starting a CP/MIHC program • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  16. Participants in initial CP/MIHC program assessment • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  17. Time CP/MIHC program has been in operation

  18. CP/MIHC program models • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  19. Comparing program type to population density • Across all population densities, the “Frequent EMS User” was selected as the most common program model. • “Primary care/physician extender” was selected as the second-most common model for programs in super rural areas. • “Readmission avoidance” was selected as the second-most common model for programs in rural, suburban and urban areas.

  20. Comparing program type by delivery model • “Frequent EMS User” was selected as the most common model for all types of private programs, as well as public-county, public-fire, and volunteer programs. • “Readmission avoidance” was selected as the most common model for public-hospital programs. • “Primary care/physician extender” was selected as the second-most common model for private-forprofit programs. • “Readmission avoidance” was selected as the second-most common model for private-nonprofit and public-countyprograms.

  21. Vehicles used to deliverservices • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  22. Equipment used to deliver services • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  23. Program operations • Can providers transport patients as needed? • Does program operate on a 24/7 basis? • Does program make house calls?

  24. CP/MIHC program funding sources • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  25. CP/MIHC practitioner deployment per patient More than four Four Three One Two

  26. Organizations partnering in program implementation Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  27. Types of program collaboration with partners • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  28. Who provides medical direction for theCP/MIHC program Committee Single Director Multiple Directors

  29. Average number of hours per week of medical direction

  30. Responsibilities of the Medical Director • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  31. Who approves clinical protocols for the program • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  32. Responsibility for the overall management of the program

  33. Program implementation • Is there a defined process for adding new services to the program? • Is there a formal strategic plan that guides the overall direction and operation of the program?

  34. Program implementation (continued) • Does the program have additional policies related to patient confidentiality? • Does the program have separate or additional liability coverage for the CP/MIHC services provided?

  35. Who participates in providing patient care • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  36. Total full-time program employees Four or more Less than One Three One Two

  37. CP/MIHC practitioner qualifications • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  38. Specific training provided to CP/MIHC practitioners • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  39. CP/MIHC practitioners • Are practitioners paid a higher rate thantraditional roles? • Do practitioners have an advanced scope of practice? • Do practitioners wear different uniforms than those worn by traditional providers?

  40. CP/MIHC program data • Is program data being collected? • Is data collection based upon NEMSIS? • Are records integrated with other health information exchanges?

  41. How program data is collected • Respondents were able to select more than one response, resulting in a percentage total greater than 100%.

  42. What program data is collected

  43. CP Survey Summary Conclusions • NAEMT’s Community Paramedicine/Mobile Integrated Healthcare Committee will continue to study this issue and bring additional information to members. • A follow-up survey is being developed to discover more information about CP/MIHC programs being implemented. • Visit the CP/MIHC page on www.naemt.org to learn more about this subject and how it is changing the role of EMS in healthcare delivery.

  44. www.naemt.org 1-800-346-2368 / info@naemt.org www.facebook.com/NAEMTfriends www.twitter.com/NAEMT_

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