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9/11/2013 2:00:00 PM
Community Paramedicine Could 'Save Money All The Way Around'
By Dominik Lobkowicz

In conjunction with four local EMS providers, Lincoln County Healthcare has applied to start a pilot community paramedicine program which could lower hospital and ambulance transportation costs, according to Warren Waltz.

If the pilot program is approved, according to Waltz, the service chief for Central Lincoln County Ambulance Service, emergency medical technicians and paramedics would make house calls in an attempt to reduce hospital visits by frequent users and to provide home health to people who need it, but do not qualify for such a program.

"The four services [CLC, Waldoboro EMS, Boothbay Region Ambulance Service, and Wiscasset Ambulance Service] in Lincoln County are going to be working together in a partnership with Lincoln County Healthcare," Waltz said.

Waltz said the partnership is hoping to receive approval as the last of 12 such pilot programs currently allowed by state law.

According to Maine Revised Statutes, the Emergency Medical Services' Board may establish up to 12 such pilot programs for up to a three-year duration.

The proposed pilot program in Lincoln County would have two medical control physicians overseeing the program, and a physician will always be available for consultation, Waltz said.

Additionally, said Richard Lash, director of Waldoboro EMS, all the patients would be referred to the paramedics by either their primary care physician or the hospital.

Initially the program would only cover patients who primarily use Miles Memorial Hospital, but would likely be expanded to provide service to patients who use Pen Bay Medical Center, Lash said.

Services which could be administered in the home of the patient include phlebotomy, blood glucose testing, assessment of wounds, patient weight monitoring, assessment of pitting edema, medication reconciliation, monitoring oxygenated blood to patients' extremities, potential fall assessments in the homes, informing the patients of other available social services, and administering vaccinations, Lash said.

Each ambulance service would operate under the pilot program in the same way, Waltz said.

"There's a huge training program that will come with all this, and it really does hinge on approval," he said.

Having paramedics perform certain functions within the home of a patient can help prevent trips to the emergency room, whether by ambulance or if the patient is brought in by a family member, Lash said.

"If we can go to the house and take care of stuff, it's going to save money all the way around," Lash said.

No additional staff would be needed to perform the community paramedicine, as the appointments would take place between emergency calls, Waltz said, and Lash confirmed.

"It would be a good opportunity for our people to use their training and skills in a proactive way rather than just responding to emergency calls," Waltz said.

Currently, Waltz said, there is no provision for reimbursement for a community paramedicine program, but if the program is approved, grants will be pursued as a way to offset operating costs.

One reason for Lincoln County Healthcare heading up the cooperative is because of the amount of paperwork, reporting, and statistics required of a pilot program, Lash said.

"If, as individual services, we had attempted to be part of this pilot program, it would have been very difficult to keep up with all the regulations and reporting," Lash wrote in a memo to Waldoboro Town Manager John Spear.

"With Lincoln County Healthcare facilitating the pilot program, it makes it less cumbersome [than] if each service attempted to pilot the community paramedicine program individually."

Though the overall program has not yet been approved, the Waldoboro Board of Selectmen unanimously endorsed Waldoboro EMS's participation in the program at their meeting on Sept. 10.

Waltz said whether or not the application for the pilot program is approved should be known within a few weeks.

"If Lincoln County Healthcare does get it approved, it would probably go online in January," Lash said.

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