ALAMEDA, Calif. — A new independent study of California’s community paramedicine pilot projects shows encouraging results, demonstrating how specially trained paramedics can safely help improve patient outcomes, reduce unnecessary emergency department transports and lower health care costs. The study by the University of California, San Francisco Healthforce Center is the first independent evaluation of California’s 13 paramedicine pilot projects, which includes successful programs in the city of Alameda.
The evaluation highlights Alameda’s “Post-Discharge Care” and “Frequent 911 Caller” pilot projects, which significantly reduced the number of unnecessary emergency department visits, lowered hospital readmission rates and helped improved overall patient care.
“Our independent evaluation of California’s Community Paramedicine pilot program shows promising results, demonstrating how specially trained paramedics are uniquely positioned to fill health care gaps, improve patient outcomes and reduce health care costs,” said Janet Coffman, MA, MPP, PhD, and associate professor at the UCSF School of Medicine. “The Healthforce Center analysis revealed many examples of how partnering with patients, rather than simply transporting them to emergency rooms, can yield positive results, and suggests the benefits of Community Paramedicine programs will grow as they solidify partnerships, secure stable funding, and find their optimal niche.”
Community paramedicine is an exciting and evolving model of community-based health care designed to provide safe, effective and cost-efficient services where access to care may be limited. Community paramedicine is designed to integrate with existing health care resources while utilizing the unique skills of specially trained paramedics and their availability 24 hours a day, 7 days a week. The program mobilizes community paramedics to perform services outside of their traditional emergency response and transport roles, helping facilitate more appropriate use of emergency care resources while enhancing access for medically underserved populations.
“These pilot projects use a geographically diverse and mobile paramedic workforce to collaborate with existing health care providers to fill gaps in the health care system,” said Dr. Howard Backer, Director of the California Emergency Medical Services Authority (EMSA). “The data from the UCSF Evaluation shows that California community paramedicine programs can improve patient care and reduce health costs in communities across California.”
“Most states deploy paramedics in expanded roles beyond what is permitted in California and it’s time for California to make better use of this trained resource of health professionals,” said Sandra Shewry, Vice President of External Engagement for the California Health Care Foundation (CHCF), which provided support for community paramedic training and the project evaluation. “These projects help under-served populations and improve care by matching patients’ needs with the appropriate resources.”
City of Alameda Pilot Projects
Post-Discharge Care:
The Alameda Post-Discharge Care pilot project was designed to reduce the risk of hospital readmissions by improving post-discharge care for people who have received treatment for chronic medical conditions in a hospital setting. Community paramedics provide short-term home-based care, working directly with recently discharged patients to ensure they understood and followed physicians’ instructions. This collaboration helped patients better manage their conditions and prescriptions, thus reducing hospital readmission rates.
Results:
Patients who participated in the pilot project had lower rates of readmission for four conditions: congestive heart failure, acute myocardial infarction, chronic obstructive pulmonary disease, and pneumonia.
Frequent EMS User/911 Caller Pilot:
The City of Alameda Frequent 911 Caller pilot (also known as Frequent EMS User), was designed to reduce the number of unnecessary 911 calls and emergency department transports by allowing community paramedics to provide frequent 911 callers with more appropriate non-emergency services. Community paramedics were trained to link patients with needed primary care, behavioral health, housing and social services, to ultimately reduce their dependence on EMS agencies and emergency departments for care.
Results:
Reduced number of ED visits among pilot project enrollees by 37%. Connected frequent EMS users with providers of services that help reduce their reliance on ambulances and EDs, including adult protective services, food assistance, mental health services, primary care providers, and substance use disorder treatment.
California community paramedicine background
Community paramedicine programs operate in 33 states. The programs are tailored to fit the unique needs of individual communities, and have demonstrated how paramedics can be trained to safely and effectively perform expanded roles, improve patient care and reduce unnecessary health care costs.
California began testing the community paramedicine approach in 2015 by conducting 13 pilot projects throughout the state. The pilot projects focused on post-hospital discharge care, frequent emergency services users (911 callers), directly observed tuberculosis care, hospice care, access to behavioral health care, and providing transport to an urgent care center instead of an emergency department for minor illnesses and injuries.
The UCSF Healthforce Center evaluation is the first independent study of California’s paramedicine pilot programs and was funded by CHCF. The new evaluation studied patient care, patient safety, financial cost and overall results. No other health professionals were displaced.
EMSA, working in partnership with CHCF, oversees the California Community Paramedicine pilot project. The program focuses on providing services where access to health care is limited. It is not meant to supersede or replace any health programs already available in the community.
To read the full UCSF evaluation, click here.