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Community Health EMS

Community Health EMS

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This is an important time for EMS and healthcare providers, hospitals and other stakeholders to engage on discussions about Community Health EMS / Community Paramedicine.  CHEMS seems to be in the agenda at most national meetings.  Many states are in various stages of planning or implementing CHEMS / CP programs.  It is time for Montana to also have discussions about the opportunities and challenges implementing CHEMS in our state and communities.

Community Health EMS / Community Paramedicine may seem like a new concept, but it has been noted in national agenda documents since the 70’s.  The idea of an EMT providing patient-centered and primary care is not new to many providers.  EMTs in Montana have probably been providing community paramedicine without calling it that:

  • EMTs who weren’t able to transport a patient, but then contacted the patient’s physician or a family member to follow up on the patient were practicing community health EMS.
  • EMTs who checked on a patient that they transported to the ER a day or two ago were practicing community health EMS.
  • EMTs who got a call from a neighbor and drove over to see if “Mom is all right” were practicing community health EMS.
  • EMTs who drove by the drug store to pick up meds while transporting the patient back home or checked in their fridge to see if they had food and milk were practicing community health EMS.

There's likely many more examples.  What’s different about this discussion is that there now may be an opportunity to formalize the practice of community health EMS and to fill gaps in the healthcare that patients need.

There may be several ways to fill these gaps – public health and home health care are good examples of programs that try to meet needs now.  There are other providers who can fill some of the gaps – community health workers, home health aides and nurses fill some of the roles already.

However, in a rural state like Montana, there are shortages in most resources and EMS may be in a position to be integrated with the rest of healthcare to help fill these gaps.  In many communities, there likely is a role for EMS to improve their community’s and patient’s health without crossing over into roles of these other programs and health care providers.  In any community, there are patients that fall through the cracks of other programs and EMS could be a solution.

What’s different about this discussion is that community health EMS may provide a path for many EMTs interested in community health and looking for a role that’s less demanding and doesn’t take them away from family and other interests so much. Community Health EMS may present new funding models that may allow emergency care providers to be paid for what they do and for EMS services to become more viable.