Paramedic program aims to cut ER visits

Helps to manage illness in home

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It is a common scenario for an elderly person who lives alone and who doesn't feel well to call 911 for an ambulance.

Many times, however, that person is not sick enough for the emergency room, but ends up there anyway because the ambulance service is not paid unless it transports the person to a hospital.

A new program in the City of Pittsburgh and the 36 municipalities that share its borders hopes to give those patients peace of mind while cutting the number of ER visits.

The Congress of Neighboring Communities is starting a Community Paramedic Program this month that will pair patients with community paramedics who will provide in-home disease management services.

Participants will be referred by doctors, hospitals or health insurers or can sign up on their own, said Dan Swayze, vice president and chief operating officer for the Center for Emergency Medicine of Western Pennsylvania.

Individuals will be assigned a paramedic who will help them manage chronic health problems such as diabetes, asthma and chronic heart disease in hopes of averting hospital trips, Mr. Swayze said.

"This program will really fill a gap that exists within our health care system -- having a community paramedic come in and check on you, make sure you have your medicine, make sure you are taking [it]," said Kathy Risko, executive director of CONNECT, which is based at the University of Pittsburgh's Graduate School of Public and International Affairs' Center for Metropolitan Studies.

The program will be available to residents of Aspinwall, Baldwin Borough, Baldwin Township, Bellevue, Brentwood, Carnegie, Castle Shannon, Crafton, Dormont, Edgewood, Etna, Green Tree, Homestead, Ingram, Kennedy, McKees Rocks, Millvale, Mt. Lebanon, Mount Oliver, Munhall, O'Hara, Penn Hills, Reserve, Robinson, Ross, Rosslyn Farms, Scott, Shaler, Sharpsburg, Stowe, Swissvale, West Homestead, West Mifflin, West View, Whitehall and Wilkinsburg.

The two-year, $600,000 project is a partnership involving CONNECT, Highmark Blue Cross Blue Shield, the University of Pittsburgh Medical Center, the Allegheny County EMS Council and the Center for Emergency Medicine of Western Pennsylvania Inc.

"CONNECT is honored to be a lead partner in this important initiative that will provide a critical service to our communities' most vulnerable residents," said Dan DeMarco, a Ross commissioner and chairman of CONNECT's executive committee.

Ms. Risko said CONNECT got involved in EMS issues in December 2009 after Mr. DeMarco asked if ambulance services in other areas were having the same financial issues being faced by Ross-West View EMS.

A subsequent report on the financial crises facing EMS services led CONNECT to ask the Allegheny County EMS Council about ways to help.

The Community Paramedic program came out of those discussions, Ms. Risko said.

Mr. Swayze said it is hoped that the program will keep medical costs down by cutting down on unnecessary emergency room visits.

"If you are a frail, elderly individual and you don't want to be a burden to your family, it is common to be anxious about every little ache and pain that you have," he said. "This gives them an alternative to 911."

Upon entering the program, the patient's assigned paramedic will visit the home to assess the patient and determine "what barriers they may be encountering to manage their health," Mr. Swayze said.

The paramedic will work with the patient as an advocate with health and human services agencies that could help, make home visits and follow-up phone calls -- even accompany the patient to the doctor's office, he said.

The hope would be to discharge patients from the program in 30 to 45 days.

An answering service will be available 24 hours a day and will include a triage unit to evaluate whether the circumstances constitute a medical emergency.

If it doesn't, the service will link the patient with his or her paramedic or an alternate if the assigned paramedic is not available.

Mr. Swayze said the first class of paramedics and program enrollment will start this month.

The paramedics will be hired by the Center for Emergency Medicine.

"Paramedics are capable. They are very highly skilled clinicians and yet we have them in this very limited role in the health care system," Mr. Swayze said.

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Sandy Trozzo, freelance writer:


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