Tuesday, November 12, 2013

TEMS Community Paramedicine Workgroup Meeting 11-12-2013

Tidewater EMS Council
Community Paramedicine Workgroup
November 12, 2013

1305       Welcome and Introductions

                Review of meeting notes from October 11, 2013
·         Accepted-unofficial

                Updates from EMS symposium meetings and classes
·         VAOEMS advisory board- (Jeff Meyer) Chesterfield program will start up next month. Their focus is on frequent flyers/loyal customers, an education program and the CHF patient population. They will start training next month with a two week course involving social services, CIT training, and rounds with a cardiologist visiting CHF patients. The program will use 3 FT paramedics and one program manager. They seem to be going for the same type of service we are trying for.
·         Home health challenge; license or not? OEMS is waiting on opinion from AG office. The advisory board has not yet met with Home-Healthcare providers. Individual agencies may get their own license but are taking a “wait and see” approach.
·         State workgroup- (Tom Schwalenberg) State workgroup is still in the “trying to figure it out” phase.
·         MEDSTAR- (Thom Schwalenberg) Met with Director of Med-Star. Examined the Med-Star process and what they learned. They started dialog with stakeholders got their foot in the door and facilitated a collaborative vs. adversarial relationship to identify service gaps in the community.
               
                General Discussion
·         Are we headed toward a regional CP program or and individual agency approach, a single call, single service may work better.
·         Council may consider a coordination role for a regional program with a central dispatch point following a nurse triage of each call with other alternative destinations using EMD.
·         We should examine MEDSTAR and RAA nurse triage systems.
·         RAA is no longer doing this due to problems with their system.
·         (Melody Siff) Wilmington and other systems have had growing pains- we should expect the same.
·         Hospice patients should also be considered.

                Education/Awareness Sub-Group
                MOC Presentation discussion
·         Need to add hospice patients to proposal.
·         Community Paramedic curriculum may be available locally if adopted. Distance learning is available approx. cost is $3000 per student.
·         Need to provide examples of successful programs to demonstrate what it will look like, what they did and why it worked.
·         Recommendation will be to develop a regional program.
·         Benefits of program are: Single contact point, greater efficiency, improved agency cooperation, Shared patient data.
·         Needs to be condensed to a 10 minute presentation
·         Need to define what “community paramedicine” is, what the pros/cons are locally, and provide a recommendation.
·         Legal and regulatory concerns related to expanded role vs. expanded scope, this is where we are today.
·         Concerns that workgroup is setting program up for an adversarial vs. cooperative pathway for the regions program by not getting stakeholders involved in the process yet.
·         (Travis) We need to get all involved parties input first- before moving forward.
·         (Schwalenberg) Informally, this information is being communicated.
·         (Foster) Is there potential for TEMS/PEMS cooperation?
·         Can this presentation be given to OMD’s?
·         This presentation must include an advisory that the next step must be identifying all of the stakeholders, educating them and do GAP analysis.

Regional Community Paramedicine Model (handout)
·         Document submitted to group for review and comment
               
                Review of data supporting scope of problem
·         Readmission reports; handouts for Bon Secours data (Travis), CGH data (Schwalenberg).
·         CHF patients with readmissions from Portsmouth, Chesapeake, Norfolk. Data is unconfirmed due to inconsistent coding
·         Data seems to suggest the problem is real but may be declining
·         Various hospitals have taken independent actions themselves which have had a dramatic effect on the significance of the problem.
·         Data from agencies going to Travis for case studies

                Committee Reports       
                None

                OEMS Report
                None

                Old Business
·         Will this workgroup request from MOC to be formalized as a committee?
·         Will wait to see what/how the group and data are received.
·         Stakeholder sub-group will be Jennifer Foster, Darren? And Liz?

                New Business
·         OMD meeting will receive community paramedicine update information.
·         MOC presentation will not be presented to OMD meeting.

                Good of the order
               

1438       Adjournment


Next meeting will be December 5, 2013 at 1300 in the TEMS conference room.

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