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Home > Topics > EMS Management
May 08, 2014

Mo. community paramedicine cuts frequent fliers by 22%

The program has also resulted in a 7 percent decrease in trips to the emergency department

ST. LOUIS COUNTY, Mo. — A new community paramedicine program implemented in February at Christian Hospital has reduced frequent 911 calls and ER visits in just three months, KSDK.com reports. 

“We’ve seen a 7 percent decrease in our non-emergent volume to the hospital through our EMS from the field,” said Chris Cebollero, chief of Christian Hospital’s EMS and an EMS1.com columnists.

There has also been a 22 percent drop in frequent 911 users as a result of the Community Health Access Program, or CHAP.

In 2013, 22 patients called 911 more than 600 times. Terrell Jones, who suffers from sickle cell disease, was responsible for 50 of them.

“I was in there a lot,” he said.

But in the past three months, he’s gone to the emergency room only twice since he started working with paramedic Derek Mollett. Mollett spends half of the week actively responding, and the other half making house calls, connecting patients to who don’t have regular doctors to primary care physicians, and getting at the root of why they’re calling 911 in the first place.

The program has helped more than 1,800 patients receive regular medical care.

“We find people coming in saying, ‘I don’t want to go to the ER, I want to go to that place you’ve got upstairs,’” said Cebollero, referring to a facility where symptoms can be managed before they escalate.

In terms of how it’s paid for, CHAP doesn’t have funding — yet. Since February, a number of insurance companies have reached out to program managers with inquiries as to how they could be involved.

Comments
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Morgan Young Morgan Young Thursday, May 08, 2014 7:38:11 PM Glad to see this program helping.
Jake Lindauer Jake Lindauer Friday, May 09, 2014 5:33:56 AM Cool the program seems to be working. Did the paramedics receive additional training for the program? As much as I like CP, I think there needs to be more education for us as providers. Maybe provide some extra skills such as suturing and removing sutures and staples. What about the ability to administer antibiotics at the residence if we notice the patient begin to be septic then discontinue and not have to transport them. Would CPs be able to write basic prescriptions or would we refer them to the doctor? Overall, I'm excited to see these programs start popping up, now I'm just curious how much we will be able to expand out scope of knowledge.
Michael J. O'Regan Michael J. O'Regan Friday, May 09, 2014 9:56:09 AM I love the idea, but how are we going to fund a non emergent ( house call unit). I know community Paramedicine is coming. It is just like the government to place requirements but no plan to fund the extra costs.
Rob Jaramillo Rob Jaramillo Friday, May 09, 2014 5:30:54 PM It's great to see a service that has implemented this program. The program probably pays for it self without having to burn fuel costs and insurance non-payment. We are trained, right patient, right drug, right dose, right time. Now it's also to get the right treatment. Evolution has evolved over time and so has Fire and EMS! Nicely done! This program shouldn't be dependent on the government. The community is getting the care they need from a service that services that community.
Chris Cebollero Chris Cebollero Saturday, May 10, 2014 7:07:36 AM Let me see if I can address some of your questions here. Michael- there are actually processes in place to get us extra funding for this program. Even Medicare has sat up to take notice. Since our beginning we have had 5 insurance companies ask US to get involved. Jake- Our Advanced Practice Paramedics have received additional training. When it is all said and done it will be more than 600 initial hours and monthly continuing education. As far as medications given in the field, we still work under our Medical Directors protocols and he is very willing to allow us to administer what needs to make the patients better. Of course, additional training will be needed for anything presently outside our initial formulary. As far as prescriptions go, this is not a present practice but who knows what the future holds. Rob- You are absolutely correct, we are shifting costs and the program does pay for itself. Kelly Grayson and myself just did a podcast on this very topic. Please join us for additional information. Share this link with your friends as we are trying to get this podcast off the ground. http://www.ems1.com/camera/articles/1899007-Inside-EMS-Podcast-Community-paramedicine-helmet-cam-usage-in-EMS/ Regards, Chris
John Hamilton John Hamilton Saturday, May 10, 2014 12:04:15 PM Medstar Fort Worth has been doing this for years and the county hospital contributes to the cost. We have a whole division of paramedic providers that are dedicated to CHP clients.

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