Community
Paramedicine Workgroup Meeting
Friday, October 11,
2013
1300-1430
Tidewater EMS Council
Office, Chesapeake, VA
1305 Welcome and
Introductions
Thom Schwalenberg, Chair opened with
introductions and review of agenda.
Discussion
on Workgroup minutes v. notes
Meeting minutes will be kept, though
not required for a workgroup, in anticipation that the workgroup may become a
committee at some point. There have been inquiries from others about meeting
activity and a need for documentation. Alan Perry volunteered to record meeting
minutes, Wendi Ambrose will assist.
Discussion
on Workgroup membership
The Chair asked what the make-up of the
workgroup should be and if a minimum level of participation should be required
from jurisdictions. A list of current participants and meeting attendees was
provided along with contact information.
It was suggested that each affected agency should, at a minimum, send a
representative to these workgroup meetings.
Mr. Porter reminded the group that all
activities of this, or any TEMS activity, are always open to the public.
Jason Stroud asked about committee
representation at MOC meetings, it is the intent of the workgroup to request
elevation to committee status at the December MOC meeting.
Discussion
on Purpose Statement
The Chair asked if our current purpose
statement was adequate, or if it needed any changes. After reviewing the
document as recorded from the previous meeting records all agreed that it was
adequate and correct. The discussion moved to the need for purpose statements
for project and stakeholder sub-groups as well.
The chair asked if the workgroup may be
overstepping its purpose. The group agreed that we should focus on developing
good recommendations for the MOC in two areas; who are the stakeholders, and
what projects would be desirable and feasible for our region.
Education/Awareness
Sub-Group Report
Presenters Ray Willet & Melody Siff
reviewed a power-point presentation they created for the workgroup explaining
what community Paramedicine is, that it involves expanded roles for providers,
and why it is needed. A review of community Paramedicine benefits and
challenges, the benefits to hospitals in achieving the “triple aim”, payment
models, Medicaid, pilot programs and cost savings occurred. The presentation is
intended to be present at the MOC, comments from the floor suggested that the
term “preventable ED transports” needs to be defined.
The presenters turned to some of the
frequently asked questions about community Paramedicine;
·
CP programs use an OMD group for supervision and
medical control, not a single OMD. Hospitals will be concerned with revenue and
patient demographics.
·
How will enrollees be targeted?
·
How will CP positions be staffed?
·
How will agencies be compensated?
·
It will involve and expanded role for providers
not and expanded scope of practice.
·
CP programs may require changes to State
legislation.
The group discussed the goals for this
presentation to the MOC. It was recommended that the presentation be shortened
and more focused addressing the legalities more specifically, the benefits to
hospitals, and describe what CP is and is not to effectively sell the concept.
It was suggested that we need to get the stakeholders behind us early.
Stakeholder
Sub-Group report
No Sub-Group members present- no report
available
Virginia
OEMS Report
Jay Porter provided information on the
options facing a CP program. If scheduled home care will be involved each
agencies, or a broader association must possess a home healthcare license.
There are only two other options, they are; getting a variance from VAOEMS, or
sub-contracting for another entity. A variance is unlikely.
Wendi Ambrose resurfaced the discussion
of the council serving as an entity for the region and become
licensed. Questions from the floor asked if that would limit the activities we
could pursue and/or upon us up to additional inspections. More research needs
to be conducted as to cost and liability.
New
Business
The question asked was how to proceed
for a pilot program. The discussion quickly turned to target patients, terminology
and definitions. It was suggested that terms such as “frequent flyers”, “preventable
ED transports” and other unspecified terms be given the standard definitions
already ascribed to them by functioning programs such as Med-Star, or large prevailing
studies on the subject matter, to avoid
confusion and allow for standardization of data.
The Chair asked what programs should be
presented to the MOC , through some discussion the group agreed to a single
target group to keep our focus narrow. CHF patients were selected and the
defining criteria for identifying them were discussed so that data can be
collected to explore the potential of the programs effects. Asthma patients and
Diabetic patients with a history of falls were also considered.
Sharing of data for research may be a
problem, agencies need to examine and/or modify business agreements with
healthcare facilities to facilitate the sharing of PHI for research.
Chairs will make contact to Travis
Mitchell of Bon Secours , and CRMC
contact once data needed to capture is determined. Thomas Schwalenberg will
make the spreadsheet for agencies and hospitals to fill in data.
Agencies represented at the meeting
proposing to share data were: Chesapeake, Portsmouth, Virginia Beach and
Suffolk.
Closing
In preparation for the presentation to
the MOC workgroup members from each agency will be collecting data from records
generated January through March of 2013 to
be reviewed for CHF Hx, chief complaint SOB w/HTN, use of CPAP and/or Lasix
pre-hospital. Hospital data will also be collected to identify all CHF
readmissions and ED visits whether transported by EMS, POV or private
ambulance. A dollar cost per readmission (average) will also be calculated
based on hospital data and EMS billing figures since the cost needs to be
quantified in both dollars and patients.
Next
Meeting
The next meeting will be November 12, 2013 at 1pm at the TEMS
office.
