Eagle Valley program aims to help physicians, cut medical costs
November 16, 2009
Eagle — People in small towns such as Eagle step up and take care of one another when illness strikes. But what if fleshing out that simple idea and carrying it through to medical professionals could actually provide a workable model for health care reform?
That's what the Western Eagle County Ambulance District, Eagle County Public Health and Colorado Rural Health Center are about to find out with a program called Community Paramedics.
The program's goal is straightforward — take a resource that already is available in the community, link it with existing health care services and provide expanded patient care including treatment delivered directly to patients in their homes. The existing resource is the paramedic corps at Western Eagle County Ambulance District.
Paramedics are, by job description, emergency medical providers. But what if they became involved in patient care before an accident happens?
"Paramedics have the training, expertise and scope of practice to provide care services such as assessments, blood draws, wound care, diagnostic cardiac monitoring and medical administration," said Chris Montera, the ambulance district chief. "And they have the proven ability to take health care into the home."
The idea of expanding the role of paramedics in community health care dawned on Montera during a conference last year while medical professionals were bemoaning an alarming and growing statistic — more and more Americans who live in rural areas are medically under-served.
When combined with the growing population of uninsured Americans, the picture looks especially bleak. As the director of an ambulance district, Montera started thinking about how resources he oversees could provide part of a solution.
From there, it was only natural for Montera to look to Eagle County Public Health as a partner. Anne Robinson, acting public health director, was hooked by the idea of Community Paramedics and what it could mean for public health's mission of preventative health care.
"If you step back, this is a very simple concept," said Robinson. "With everything going on with health care reform, something needs to change. But how?"
There is no mdoel for the program, but it has support from primary care physicians in the area as well as local politicians. Both Vail Valley Medical Center and Valley View Hospital in Glenwood Springs are willing to test the model.
Dr. Benji Kitagawa, an emergency room physician at Vail Valley Medical Center, and Dr. Drew Werner, a primary care physician at the Eagle Valley Healthcare Center, have signed on as the program's medical directors.
"I am absolutely, definitely convinced this is something that will work," Werner said. "The Community Paramedic model is totally designed to work with primary care providers to provide patients with a medical home."
As the nation debates health care reform, Werner said a perfect storm is on the horizon. With universal coverage, millions of new patients will come into the system at the same time when the corps of primary care doctors is being depleted.
"Health care is in so much distress and we are not training people as quickly as we are going to need them," he said.
But with the Community Paramedic model, doctors can use services already available in the community to extend their reach.
From checking blood pressures to wound care, Werner said he could think of dozens of ways to use a paramedic.
"The paramedics will not be acting outside of their current set of abilities," Werner said. "We are just using them in a much better way."
The current proposal is for a five-year pilot with the education component beginning this winter. The ambulance district will require community paramedics complete 100 hours of classroom instruction, through Colorado Mountain College. Another 100 hours of clinical time will be chalked up in local doctors' offices, hospitals and public health clinics. Those requirements will take a few months to complete but Community Paramedics should be in service by June or July of 2010.
In a few years, Montera and Robinson hope to have accumulated enough cost-saving evidence to present the model to insurers. Up until then, they hope to fund their program with grant money.
"Whatever your political view on national health care reform is, in my mind, that's not what this is about. This is about people," Montera said. "This program is about patients. It's about linking medical care throughout the community."