County Fire Participates in Pilot Healthcare Program

San Bernardino County fire will participate in a statewide pilot project aimed at studying Community Paramedicine (CP) and its value. San Bernardino County is one of 12 locations chosen to participate in the 12- to 18-month program, which will study various aspects of CP. San Bernardino County Fire Chief Mark Hartwig said, "The goal of this program is to augment the patient’s current plan of care with resources currently established within the community, which will provide the patient with the necessary education and tools to maintain and improve wellness outside the hospital setting.” The County Fire department will partner with the Rialto Fire Department, the San Bernardino County Department of Public Health, Arrowhead Regional Medical Center and the Inland Counties Emergency Medical Agency (ICEMA) to provide a post discharge follow-up visit to a congestive heart failure (CHF) patient’s home, perform a detailed physical assessment on the patient and ensure the patient is maintaining or improving their post-hospital discharge status. During the follow-up visit, the community paramedic will also verify the patient’s understanding of their disease process, discharge medications and follow-up plan. Should the patient require further medical treatment and the community paramedic will assist the patient in accessing primary care or fulfilling their healthcare need. Recently San Bernardino County Fire Training, Special Operations & EMS Section kicked off the training of 17 firefighter paramedics (10 from San Bernardino county, five from Rialto, one from Fountain Valley and one from Huntington Beach) for this healthcare model. What is Mobile Integrated Healthcare (MIH) and Community Paramedicine? In short, MIH is the provision of health care using patient-centered, mobile resources in the out-of-hospital environment. Since the creation of modern emergency medical services, EMS has largely been considered a transportation system for people suffering a medical or trauma-related healthcare emergency. However, recent changes in healthcare have created an opportunity for EMS to evolve from a transportation service to a fully-integrated component of the nationwide healthcare system. EMS is situated within the communities and with the proper medical oversight can efficiently and effectively direct patients to the right care, in the right setting at the right time. Community Paramedicine is one aspect of MIH in which paramedics function outside their customary emergency response and transport roles in ways that facilitate more appropriate use of emergency care resources or enhances access to primary care for medically underserved populations. The focus is on providing services, where access to care is limited, or a short-term medical intervention is needed. CP programs are typically designed to address specific local problems and vary in nature. Interest in CP has grown in recent years based on the belief that by targeting local health care needs, and offering a creative solution to fill local health care gaps, CP helps increase access to care, and can reduce health care costs by providing a level of care based on the individual’s medical needs. Community Paramedics will complete over 160 hours of classroom training and clinical work, to include detailed CHF patient assessment, medication reconciliation, laboratory valuations and home safety inspections, as well as learning of community resources and more. The program is expected to begin by the middle of this year, with San Bernardino County Fire Community Paramedics testing the program in Fontana, Hesperia and Victorville. The goal is to reach out to CHF patients within the first 48-72 hours of being released from Arrowhead Regional Medical Center. San Bernardino County is home to one of the largest per capita populations of congestive heart failure (CHF) patients in the U.S. Sufferers of this condition who either poorly or mismanage their disease depend on the emergency medical system (both 911 and hospital emergency departments) to keep their condition in check. Through these interventions, the goal is to decrease the rate of re-admission to the hospital, the necessity to access 911 for non-emergency situations, and ultimately improve the quality of life for the patient population.