Innovative EMS Services, Where Are You?

[kevkei]

Hey all, I have an info request for you.

I am currently involved in a project that is looking at innovative and creative ways to deliver alternative forms of EMS that fall outside of the traditional scope of respond, treat and transport to a hospital.

Specifically some examples of what we are looking at:

• Expanding the scope of practice for EMT’s and Paramedics, something akin to a Paramedic Practicioner (Somewhat resembling a P.A)

• Taking the hospital to the patient in an attempt to meet the patients ‘needs’ as opposed to their wants.

o Examples of this would be access to a large referral network.

o Working with primary care and urgent care networks possibly with the ability to transport patients to areas other than a hospital E.R

Some services that we are researching are Metropolitan Ambulance Service in Melbourne Australia, the National Health Services model out of the United Kingdom, MEDIC Mecklenburg EMS Agency Charloette/Mecklengurg Co. N.C as well as Richmond Va.

Do you or your service have any experience in these areas or do you know of anyone that does? If so, I would like to hear from you. Drop me a P.M

Thanks for your consideration,

Kevin

[somedic]

It all sounds interesting. Keep us posted.

With every best wish for the holiday season,

Somedic

[zippyRN]

it's not going to happen in the USA until you can bill for it ...

[kevkei]

it's not going to happen in the USA until you can bill for it ...

If you will take a moment to look, you will notice that I'm not from the US.

[AZCEP]

it's not going to happen in the USA until you can bill for it ...

Actually, Phoenix fire department had a similar program for a while. They were using PA's and NP's as a backup to their ALS crews. The ALS crew would respond, assess the situation, then call for the additional help. I'm not sure if it is still in practice, as the PA/NP's found out they could make better money in an office than they could working for the fire department.

Most places do allow providers to refer non-emergent patients following a consult with medical direction. They also get to bill at a greatly reduced rate than if they transport. Here's an article from JEMS about an agency in North Carolina doing this.

http://www.jems.com/products/vehicles/articles/243886/

[kevkei]

Does anyone else have anything to add to this at all?

[Dustdevil]

Does anyone else have anything to add to this at all?

I truly wish I could say I did. I wish that being innovative and progressive was common among EMS providers in this country. Quite obviously, it is not. Private enterprise is usally at the forefront of progress and innovation in industry and healthcare. That's why this is such a great country. But government holds all the pursestrings in healthcare here. Consequently, there is no incentive for the EMS industry to do anything except what is just enough to get their Medicare payments. And you get what we have now. Dick.

About the only system in the US that I am familiar with that could *possibly* qualify for your topic would be Acadian in Louisiana (and lesser in Texas and Mississippi). They have an offshore division as well as an industrial division employing both medics and nurses. They run their own offshore medicine school too.

[BushyFromOz]

Does anyone else have anything to add to this at all?

I do, but it involves someone from the UK not butting in on US issues which they cant possibly know enough about.

Metropolitan Ambulance Service was my suggestion but i see you already have that. Queensland Ambulance may be a winner for i believe they have training packages that are tailored to the area their people work in. i.e. coastal guys get additional training in sea creature envenomations v rural remote who get additional training in extended care, though i may be wrong

just a thought

[kevkei]

Queensland Ambulance may be a winner for i believe they have training packages that are tailored to the area their people work in. i.e. coastal guys get additional training in sea creature envenomations v rural remote who get additional training in extended care, though i may be wrong

just a thought

You are correct on Queensland, although it is more in depth than that.

Dust, there are places in the good ol' U.S of A that are doing something like this, although most are either hospital based or are municipally (or county) based services. Once I get more info, I can post here who and where they are if you would like.

[Chrisclark]

You know...

I would not at all be surprised to see a new level arise in EMS over Paramedic, maybe a Paramedic Advanced or Paramedic Practitioner. They would be allowed to push more drugs and perform more advanced procedures. This is only expected though since as technology expands the scope of practice expands too.