It used to be that if an ambulance was parked in front of someone's home, there was likely a medical emergency. Now, that’s not always the case.
With ever increasing budget cuts, a declining number of family practice physicians and the desire for many ailing seniors to stay out of traditional senior living centers like assisted living facilities and nursing homes, health systems are developing innovative ways to serve the patient base. In several states, paramedics are now being used to provide non-emergency services to home-bound patients.
According to an Associated Press article posted on MSNBC, the paramedics are able to do such tasks as draw blood, check blood pressure, change bandages, and check medication compliance. These are all basic tasks done by paramedics regularly in the field. “Instead of taking out the blood and guts, this is a move into preventative care, so people don't have to call 911," reported Eagle County Colorado paramedic Kevin Creek.
The Colorado pilot-program is designed to see if there are financial and health benefits to using paramedics in this capacity. With its 52,000 Medicare-eligible residents, officials are hoping to see savings at both the state and federal levels. Currently, funding is being provided through a $700,000 grant, but the goal is to have Medicare and Medicaid eventually agree to cover the costs.
Paramedics working in this capacity are not making medical decisions independently; they are working under the supervision of participating physicians. Medical information collected during visits is evaluated by the doctor who will ultimately decide the course of action. "We're the eyes and ears of the primary care physician in the home," said Lisa Ward, program coordinator. "It's out-of-the-box health care, and it's the future."
For many seniors who are foregoing skilled nursing care and assisted living homes, this can be a win-win situation. The chronic diseases that often plague the elderly and lead to many hospital admissions like diabetes, congestive heart failure and COPD, can all be monitored by paramedics in this program without patients making the arduous trip to the doctor’s office or hospital. It’s reminiscent of days gone by when house calls were common place.
For non-emergencies only?
But if paramedics are providing preventative care, who will be available in the event of a true emergency? Dr. Jeffrey Beeson, past president of the American College of Emergency Physicians, believes such programs can, in fact, reduce the number of ambulance calls. In a similar program in Fort Worth, Texas, paramedics have visited more than 200 patients when they would have otherwise been waiting for emergency calls.
The answer to this question may lie in Eagle County’s pilot program. The grant, which is provided by the Colorado Department of Health, two private health organizations and the ambulance district, has provided opportunity for Creek and a colleague to be assigned to providing these services to its residents. This way, there is no shortage of emergency personnel.
So, don’t be surprised if in the near future your doctor decides to make a house call. Only, it most likely will be the local paramedic who comes knocking instead of the doc himself. Would you be comfortable with a paramedic performing basic, non-emergent care for your loved one?
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