Community Paramedicine: the Hennepin EMS pilot

Report
Doug Gesme, MBA, EMT-P
Dave Johnson, CP, CCEMT-P
Our program at present

One Community Paramedic
 M-F 0700-1600ish

15 Current regular clients
 20 clients is goals load
 Ages 7 to 105
 ~50 total client interacted with

Ideal and Actual clients are often
different
Target Population

Chronic, Non-Transmittable Disease
 Cardiovascular, Diabetes
Most have subordinate Chemical
Dependency / Mental Health Issues
 High-Risk for readmission or avoidable
ER use
 Ineligible/Unwilling/Inaccessible to
Home Care RN/PHN

Identify your Players

Advanced Practice Providers
 Innovative, Respected and ACCESSIBLE
Administration
 Care Coordination groups

 Healthcare Home, Clinical Coordinators,
Case Managers, Discharge Planning
Our next steps
Executive Leadership Blessing
 Completion of Clinicals for 12 students

 10 HTC, 2 Inver
 May have three certified late January 2014
When EMS wants to do something, we do it.
When the corporate world wants to do
something, they have meetings about
meetings.
Patience!
Clinical Process

Hennepin Tech has quality offerings
 Not a perfect match for HCMC’s program
Clinicals should be based on
organizational needs
 Great opportunity to identify needs
 Clinicals are a great relationship building
opportunity

Clinical Experience

HCMC

 ER
 Coordinated Care

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Center Clinic
Senior Care Clinic
Home Visiting Program
Burn Center ICU
Medicine Clinic
Community Health
Workers
Hennepin Co HSPHD
 Healthcare for the
Homeless
 Project Homeless
Connect
Minnesota Visiting
Nurse Agency
 Home Care
 Hospice of the Twin
Cities
 Hospice of the Valley

St. Stephen’s Human
Services
 Street Outreach

Scott County PH
 Mobile Free Clinic

Golden Valley
Health/Rehab
 Wound Care
Our Resources

VisiCAD Integration
 “EMS-CP1”
 PNC “EMS Scheduled Event” used

ARMER Radio Resources
 “HC_BUS” for primary operations

HCMC IT Connection
 Epic Department “HCMC COMM PARAMEDIC”
 Sprint 4GLTE Connection



Cell Phone & Pager
iSTAT Point of Care (CHEM8, CG4+, PT/INR)
EMS Administrative Vehicle (Thanks Doug)
Our Learning Points

Relationships are Everything
 Ensure you are not stepping on toes
 Less Productive time is VERY Productive time
Understand your target population
 Don’t try to re-invent to wheel

 Share in and support existing success

Profit is a very funny word
 ~3% reimbursement of our pittance
 Cost Avoidance
Relationships
Some are obvious
 Primary Care
 Home Care
Agencies
 Ambulatory Care

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Many are not
Laboratory
Pharmacy
EHR
Social Services
Food Shelf
Homeless Services
Interpreters
And on and on
and…
MY Learning Points
You are not managed by dispatch.
 Productivity is no longer UHU’s

 Design your workload and manage it well

Work Life / Personal Life Balance
 You will bring work and Progress Notes home
with you
 Your SO will get sick and tired
Client Access is key
 Don’t let admissions bother you. They are
inevitable.

Questions

David Johnson
 [email protected]
 612 396 6935

Doug Gesme
 [email protected]
 612 393 5437

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