The Kanawha County Emergency Ambulance Authority created the community paramedicine program in May 2017 to fill the gaps in health care that no one else can.
Monica Mason, director of clinical services and education at the ambulance authority, said the community paramedicine program serves the “frequent flyers” or “high-utilizers” of 911 emergency calls and hospital visits.
“Community paramedics work with hospitals within our area and they see patients post-discharge from the hospital that the facility feels are at an increased risk for readmission,” Mason said, “and what the community paramedic will do is go out and see that patient 24 hours, 48 hours after their discharge from the hospital.”
“We do medication reconciliations with them, go over their disease processes, answer questions that they may have,” she said, “and make sure they have their doctors appointments scheduled and follow-up appointments.”
Community paramedics are a lifeline for some of Kanawha County’s most vulnerable residents.
“[Hospitals] don’t really have the follow-up with those patients,” Mason said. “With community paramedicine ... they get to know those patients, they get to know their families, they get to know their providers and get to help coordinate that patient care.”
The social determinants of health — lack of quality health care, unreliable transportation, low educational attainment, low-paying jobs, food insecurity, etc. — are the drivers behind chronic health conditions that lead to frequent hospital trips, Mason said.
“There may be an underlying reason why they’re calling — they don’t have access to transportation to get to the doctors, they may be out of their medication, they live alone,” she said. “But sometimes those patients know they just need access to care, and that’s where the community paramedics can go in and help them.”
Trish White, one of the ambulance authority’s community paramedics, will often be one of the medics responding to these patients when they have their medical emergency. That’s important, White said, because she can get to know them and their battle from the beginning.
“You build up a trust with the patient … on the 911 side you may see them again after you take them to the hospital … you get to see their process and you get to see them get better,” White said.
White said it’s all about setting achievable goals for patients, whether it be walking from room to room without losing breath or fully regaining strength.
For White, she’s responsible for leading the patient’s care and pulling together all the available services for them, like therapy, food pantries, nonprofits, senior services or hospice care. Community paramedics also work to find patients affordable and quality health care.
And they make sure patients don’t have a home environment that may put them back in the emergency room.
“They go in the home and they check their home safety inspection to make sure the home is safe,” Mason said. “Does it have working fire alarms, are there any safety issues within the home like trip hazards that may make an elderly person susceptible to a fall that may increase their risk for a hip or a leg fracture, which can be detrimental for certain patients.”
White plays dual roles for the ambulance authority. She’s also a member of the Special Operations Team, which deploys to disaster areas in the United States to assist in emergency medical response.
She just returned home from Louisiana, where the Special Operations Team spent more than a month caring for Hurricane Laura evacuees. White performed community paramedicine there, checking vitals, administering care and filling prescriptions for evacuees in hotels-turned-shelters.
Mason said this community-centered health care method is progressive, innovative and is in line with the future of medicine and emergency response. Telemedicine and treat-from-home protocols will soon be a mainstay in health care, and the ambulance authority is two steps ahead.