Community paramedicine (CP) is an adaption of current services within communities, emerging as a response to the health care crisis. The model increases access to basic health care services through the use of already existing health care providers in the emergency medical service (EMS) field that are provided with additional education in order to extend their role. Community paramedicine expands the reach of primary care services by using a paramedic to see a patient in their home or community setting, and perform procedures already in their skill set, under the supervision of an ordering physician or advance practice provider. With 25 percent of the nation's population living in rural areas and only 10 percent of U.S. physicians practicing in those areas, it makes sense to tap into EMS personnel that already live and work in rural communities, to augment services and extend health care access. The field of EMS has been moving in a more community-based direction for sometime. In 1996, a National Highway Traffic Safety Administration report presented the vision of EMS as more community-based and fully integrated with the overall health care system. A 2004 article, """"""""Rural and Frontier EMS Agenda of the Future,"""""""" described a vision of EMS personnel providing not only a rapid response, but also filling roles in terms of prevention, evaluation, triage, referral and advice. Over the past decade, paramedic treatment of non-acute illness in community settings has evolved and formalized into a field called community paramedicine. In the mid 2000s, the model gained momentum as community paramedic programs began developing around the country as a strategy to fill local health care gaps. In 2010, the Joint Committee on Rural Emergency Care (JCREC), comprised of members from the National Association of State Emergency Medical Services Officials and the National Organization of State Offices of Rural Health, issued a discussion paper which called the model """"""""One of the most progressive and historically-based evolutions available to community-based healthcare,"""""""" and further praised its potential to decrease emergency department utilization, save healthcare dollars, and improve patient outcomes. The paper also documented both opportunities and challenges for this newly emerging field, including key issues that should be addressed on a national scale.
The aim of the conference is to advance the field of community paramedicine toward a vision of full integration with public health, community-based health, support programs and the entire health care continuum. The meeting's framework will be based on the key issues raised in the JCREC discussion paper, including: education/training, regulation, medical oversight, research/evaluation, practice, reimbursement, and service integration. Examples of the target audience for conference attendance include state EMS directors, state rural health offices, EMS professional organizations, local community paramedic programs, medical professionals, representatives from payer sources, researchers/ academics, graduate students, and those serving tribal communities. It is estimated that 40 to 50 participants (including panelists) would attend. An expert panel format will be used to examine each issue and determine how to address it. All participants will be contributors to the discussion. Panel presentations, discussions and recommendations will be synthesized into proceedings that will include both action plans and next steps. Proceedings will then be published and distributed widely to inform future work in a strategic and coordinated manner. The advancement of community paramedicine as an available strategy to address health care gaps in all states, is consistent with the AHRQ mission of """"""""improving the quality, safety, efficiency, and effectiveness of health care for all Americans"""""""". Additionally, the model meets multiple national Healthy People 2020 objectives with regard to improving access to comprehensive, quality health care services.

Public Health Relevance

The community paramedicine model is relevant to public health because it improves the ability of individuals, communities and providers to prevent disease, prolong life and promote health by incorporating specially trained emergency medical service (EMS) providers as intercessors and liaisons for patients to gain access to a wide variety of preventative and health management efforts. Effective implementation of the community paramedicine model can effectively reduce the prevalence of acute health issues, ambulance transports, emergency department utilization, and hospital readmissions, resulting in improved health, improved quality and extensive cost savings. Fundamentally, the community paramedicine model meets many Healthy People 2020 objectives by increasing access to primary and preventative health care by deploying existing resources in innovative ways. !

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Conference (R13)
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Special Emphasis Panel (ZHS1-HSR-T (03))
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Hagan, Michael
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North Central Ems Institute
Saint Cloud
United States
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