TEMS CPM Meeting
September 25, 2013
Conference presentation- Ray Willet, James
Holzer, immediate change is needed, EMS will not be the same in 5 years. 110
working programs in usa US.
Transistion from EMS to Unscheduled EMS.
Manage high risk refusals and other
non-transports
Plan/schedule non-emergent patients
Separate can do from must do
Not home health, resource for home health
Region needs single contact for CPM services
Educate other healthcare providers about role of
EMS/CPM
EMSinitially designed for trauma emergencies,
that is no longer the case
If we do not embrace CPM, hospitals will.
Fewer paramedics increases paramedic skill levels
Benifits/Risks not fully understood
wake County NC system example
The 3 R's= respond, redirect, reduce
Community health, substance abuse, fall
prevention, HTN, CHF, DM
CPM fits EMS scope of practice model
Quick Legal View
Potential for expanded liability
No major legal obstacles
No percieved increased liability
Other effected parties may not feel the same way
Some large losses
lawsuits are successfull only 25% of time
No claims agiants any CP or MIHP programs
Defininition of scope of practice not limited to
EMS regs, grey areas exist
EMS regs state we must operate within the agency
EMS license relating to circumstance in which care is provided.
Scope of Practice v Standard of Care
State of Va
Chesterfield process asked to slow down
m.Berg recieved call from home health nurse in
Roanoke, Carrillion EMS acted independently and offended because they did not
communicate
Scheduled care may violate EMS licensure
requirements
VAOEMS will not allow waivers for this, a home
health license must be obtained currently
Failure to communicate with stakholders has been
primary failure so far
VAOEMS suggests moving slowly, without exceeding
scope of practice
(note: this meeting had no other stakholders in
it)
There may be some mounting opposition to CP
activities in Virginia
Alexadria may have a program model utilizing PA
to manage program
Suggest any proposal go up through TEMS with
stakeholder endorsments to VAOEMS
Current VA regs prohibit scheduled home based EMS
services
Home health has a 24-48hr window post discharge
before they can see a home patient
*russ blow-include in correspondence
Closing
We know what needs to be done
We need to bring in the other stakholders within
the region
Start with somthing small and achievable
need 2 working groups, one for stakholders, one
for workable ideas
Target date for presentation is November 2013
What is cost per patient, to hospital? to EMS
agency?
Next meeting October 11, 2013
EOM
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