ROCHESTER, N.Y. -- It’s hard to imagine, but a portion of 911 calls in the city of Rochester come from repeat callers. In most cases, paramedic and Monroe Ambulance Patient Care Deputy Chief Mike Bove says the call, and expensive trip to the emergency room, could have been prevented.
“We encounter a lot of people that had they had better care instructions at home or not necessarily better care instructions, but better preparation; there are a lot of people out in the city of Rochester that don’t have primary care,” Bove said.
In an attempt to keep these people out of the hospital and their possible chronic illnesses in check, Bove has spent the past year learning about preventive care through a course at Hennepin Technical College in Minnesota.
“It involves primary care,” Bove said. “It involves wound care management, management of chronic diseases, things like diabetes, and people with congestive heart failure…In the world of EMS, Emergency Medical Services, we respond to emergencies. We are well versed in taking care of people that have emergencies: heart attacks, strokes, diabetic emergencies, broken legs, broken arms, car accidents. This is now the total opposite of that. We are learning how not to take people to the hospital and how to keep them out of the hospital to reduce the burden on them. Again, with healthcare reform, the hospitals end up getting fined or they don’t get paid for certain re-admissions and that type of thing. So now we’re learning the whole opposite spectrum and that’s how to take care of people and be able to keep them in their homes.
Through this training, he hopes to start up a Mobile Integrated Healthcare, also known as community paramedicine, program at Monroe Ambulance.
“Physicians don’t make house calls anymore, but guess what, we can, so we’re an extension of that physician and to be able to provide preventive care, education on diet, counseling, and look at the whole social economic picture and what’s best for the patient and make those recommendations back to their physician,” Bove said.
Bove said patients who don't qualify for home care service would get referred to them by a physician or other source.
“Ideally what we would like to do is, at time of discharge, we would hopefully be able to accompany that patient home,” Bove said. “We would provide a safety inspection of the home to make sure there aren’t any hazards or anything that would lead to somebody exacerbating their condition or making that condition worse.”
They would also help the patient with their medicines, social needs, linking them up with resources, and helping them with any other aspect that might cause the person to call 911 soon after arriving home from the hospital. They would then set up follow up appointments when needed.
The only hang up in getting this program started, however, is New York State doesn’t currently have laws in the books that allow emergency medical providers to practice community paramedicine. There is a bill currently in legislature, and if it passes Bove hopes the program will help reduce the burden on emergency rooms and free up ambulances for more serious emergencies.
“It’s like you know we can help,” Bove said. “We can do something about this. We can make this better. That’s why we’re excited about it and that’s why we’re hoping the legislation will allow us to do all this.”
Bove said Monroe Ambulance is currently the only ambulance service in the city that has a non-emergency medical transport division and they would use that to aid in the program. Bove said he and two other paramedics have gone through or are going through the course. He said not only is the course a 14 semester hour class, but they must also complete nearly 200 hours of clinical experience.