NC Midstate Hospitals Look to Reduce Hospital Readmissions with EMS Home Visits

July 15--CAMP HILL -- Sometimes when a patient has a surgery or is prescribed a complicated medicine or is taking multiple pills for an ailment, things can get confusing.

So hospital systems in the Midstate are aiming to help curb that confusion by offering up emergency medical professionals to make house calls for certain patients.

Paul Christophel, the executive director for West Shore EMS, said they started a program at Holy Spirit Health Systems in April and have so far seen about six patients. They are hoping it picks up once the medical community starts to become more educated about the program.

"It's really about trying to keep people at home," he said. "We have to educate our own health-care partners as well as the community."

The program aims to reduce readmissions to the hospital by having a trained paramedic, who is assigned as non-emergency for that shift, stop by patients' houses and check to make sure they received their medicines and know how to take them, Christophel said. The people this program will help are those who may need some help managing their health care but are not eligible for home health-care options.

The main goal of the free paramedicine program is to fill in the gaps that are left in the system.

"Basically it's using emergency medical technicians and paramedics in a non-emergency role to see patients in their home that are either chronic disease patients or some kind of follow-up," Christophel said. "Home health usually does those, but sometimes folks don't qualify for home health or they refuse home health. We're trying to fill in the gaps where home health isn't."

Right now the program at Holy Spirit is referral-based and mostly focused on congestive heart failure patients who don't qualify for home health care. However, it will likely expand once the program gets its feet wet.

Trend in care

PinnacleHealth Systems has a similar program in place that began in January 2013. The Community Paramedic Program involves paramedics making home visits in the days and a week after discharge to make sure that the patient understands the physician's instructions and that everything is well.

For the PinnacleHealth program, the professional makes at least two visits. In the first visit, they check the patient's blood pressure, pulse, respiration and weight, as well as make sure the patient received all of the prescriptions and is taking them correctly. Then, they will come back a week later to check the same things. If there is a need, the community paramedic will make plans to come back.

Right now, there is one paramedic assigned to the Holy Spirit program, which is still in its infancy. However, Christophel said they plan to have three people in rotation by the end of the year. There is additional training for the paramedics involved in the program.

"There's a formal curriculum that we have not completed yet that has recently come about," Christophel said. "In the meantime, they've had training with our Holy Spirit home health and patient center medical home navigator, folks from their physician services. (They need to learn) that things are not an emergent, emergent thing. They take their time with their patient, because they're probably going to be with the patient for one to two hours. Right now, we're used to only being in the house for a few minutes."

The program will help reduce the readmission rates by helping patients have the proper follow-up care. Christophel said that sometimes people don't understand the instructions and follow them incorrectly or they just don't do them at all, so having this option for some will increase patients' abilities to stay healthy after surgery or other health event.

While programs like these are popular in Texas, North Carolina and Minnesota, it's a newer trend for the Midstate and Pennsylvania. Christophel said because health care is trending toward more outpatient care and fewer invasive, inpatient procedures and appointments, it will likely catch on more in the coming years.

"I think probably, at some point, we're going to see the volumes increase, and we'll have to dedicate more people to do it," he said. "There will come a time where it starts to have a lot more referrals once people are educated about it. We're not replacing anyone, and we're not doing something new, it's just filling in the gaps to make sure that people get the care that they need."

Email Samantha Madison at smadison@cumberlink.com or follow her on Twitter @SentinelMadison

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