Objective: Our pilot Community Paramedicine program seeks to reduce unnecessary Emergency Room visits and hospitalizations by allowing for urgent assessments in the field by paramedics and coordination of care with primary care specialists via telemedicine.
Who’s Participating?
Mobile Acute Care Team (MACT)
Mount Sinai Visiting Doctors (MSVD) program.
Mount Sinai Performing Provider System (MS PPS – DSRIP)
How Does It Work?
When a patient calls their physician (or other clinician) for a potential emergency, the physician can dispatch a non-911 Emergency Medical Services (EMS) unit staffed with a specially trained paramedic to visit the patient at home without immediately transporting him or her to the hospital. These units will be able to respond to the home within 30-60 min. Upon arrival and with the help of telemedicine technology, the community paramedic will then participate in real-time consultation with the referring clinician and/or the REMAC authorized “Telemedicine Physician” in order to make a coordinated decision as to the appropriate course of action.
How is this different from calling 911?
In this model, paramedics are empowered through physician consultation to deliver care and administer medicine to a patient who might be best served by NOT going to the hospital. The physician, assisted by the on-scene paramedic will engage the patient to make a shared decision about when and where the next steps in care should be provided. As such, the activation of EMS is no longer seen as a failure of care coordination, but rather an opportunity for additional care coordination to occur.
How much training is involved?
Paramedics receive 16 hours of education that included both didactics, scenario based discussions, operational instructions, and a structured clinical observation experience with an MSVD physician. Physicians formal certification through the NYC REMAC (Regional Emergency Medical Advisory Committee) to participate in “telemedicine” with the community paramedics in the field.