EMS is in virtually every fire department across the United States in some form, and while the demand for fire suppression is down, EMS is facing new hurdles requiring our attention. Emergency departments are overcrowded, our budgets are shrinking and new rules in Medicare that affect our primary clients are fast approaching. Starting this July hospitals will receive no money from Medicare for return visits of certain patients. You read it right—no reimbursement to hospitals for repeat patients with certain conditions within a certain time. Yet, we frequently transport the same patients to hospitals.
There aren’t many who have escaped the downturn of the economy and that includes the fire and emergency service. Though experts have said we’re making a slow recovery, we won’t see the budget of years past. But even after the economic downturn and now the slow restoration, we continue to operate in the same mode we have for the past 60 years.
We try to do business as normal—but normal is a relative term. Unless we adapt to the new world, our existence is in jeopardy. We can no longer do things the way we’ve always done them. It’s time to change how we do business!
U.S. Department of Health and Human Services recognized the importance of change and even offered grant money of up to one billion dollars for pilot projects delivering EMS in a different format.
The exact outcome of all these changes can’t be predicted. The future delivery model of EMS may be nothing like we see today; quite frankly, we can’t sustain the model we know today.
However, in response to the changing EMS environment, more and more states are taking up the idea of community paramedicine. It isn’t new; several communities across the country are already using community paramedics. Community paramedicine has also shown results in other countries around the world.
Don’t confuse community paramedicine with advanced paramedics. Community paramedicine is a means to provide alternative treatment and transport to those in your community. It has reduced transports in some locales by as much as 50%.
It provides a means to do business differently, keeping the patient in mind across the spectrum of the entire healthcare process.
The IAFC’s EMS Section has created a new committee, Community Paramedicine, to consider new ways to approach EMS. The committee met for the first time in April; it will provide insight and updates to members on best practices and ideas on how to implement a community paramedic program in their departments.
We’re entering a new beginning in EMS. Fire-based EMS is at the forefront of EMS care in this country, and we must organize and participate so we don’t find ourselves at an even greater disadvantage in our communities.
The future is ours if we capitalize.
If you have thoughts, best practices or interest in your community, please email Jeff Lindsey.
Jeffrey T. Lindsey, PhD, EFO, PM, was fire chief of the Estero Fire Rescue. He was honored with the James O. Page EMS Achievement award at FRM 2011.