Integrated Healthcare Forum Sheds Light on New Ways of Delivering Patient Care

The future of EMS lies within the integrated healthcare continuum, and to that end the Integrated Healthcare Forum was co-located with this year’s EMS World Expo in Nashville, TN.

Experts from across the fast-growing field of integrated healthcare joined together to present information on education and training requirements across the spectrum of healthcare providers; pilot projects across the country; developing contracts with payers; and utilizing and implementing patient care data. Meanwhile, attendees learned how to conduct a community assessment to develop an integrated healthcare program in their area, and found out how integrated healthcare serves to meet the Institute for Healthcare Improvement’s Triple Aim of better health, better healthcare and reduced costs.

A good portion of the forum was devoted to the education and training component, as special skills are required of community paramedics. In particular, Anne Robinson Montera, RN, BSN, a public health nurse consultant from Colorado, said the paramedics best suited for work in integrated healthcare aren’t just those with years of practical experience under their belts, thought that’s still important. Rather, what’s required of paramedics if they’re to be community paramedics is a natural tendency to spend some extra time with patients, looking beyond the immediate health concern to the patients’ entire health picture.

What Montera’s found training paramedics is that they have to learn about prevention and what prevention looks like, instead of just treatment.

Panelists also discussed the scope of EMS education and advocated moving beyond the comfort of the classroom to more clinical time. Specifically, panelists wondered aloud why EMS education isn’t integrating with the rest of the healthcare system the way EMS practice is being asked to. For example, during simulation, why don’t students take patients to the ER and work with the hospital system on transferring care? If EMS is truly going to integrate with the rest of the healthcare system, it needs to do so at all levels.

Models of reimbursement were also discussed. EMS agencies are going to have to work with their partners in the healthcare system to get them to understand the benefits of this new way of offering care. Part of that education process is getting payers to see the value in paying EMS to keep patients out of the hospital, such as is already happening with CHF patients in some programs. One thing panelists emphasized was the need to retain all rights to data when contracting with different payers and health systems. It sounds minor, but that data is what the agency is going to use to sell itself to other customers as its mobile integrated health program grows.

Finally, regulation was addressed. There are many unknowns in regard to implementing integrated healthcare delivery programs in our communities. Each state has different rules and laws governing the kinds of activities EMS providers and agencies can be involved in. It’s important, panelists said, to get to know and work closely with local, state and federal lawmakers to get them to see the importance of integrated healthcare and the role experienced, trained EMS providers can play in improving patient care and reducing costs. Home health workers and nurses often have powerful unions and lobbying groups, and their voices are heard on issues that affect their roles in the health system. EMS providers need to have an equally powerful voice to ensure they’re not left out of the integrated healthcare system.