Who's Taking the Fall?

“I think there would be no way to safely validate this protocol without all the safety stopgaps we have,” says Myers. “By this group consenting all their patients, we have a very tight group we can monitor. But if the protocol is actually validated, our plan is to roll it out to the broader community. So our hope is that we have a safe way to validate it. It’s very objective; the only question would be if the patient received timely follow-up. And in the world of healthcare reform, it sure seems payers might be willing to pay for a 12- or 24-hour follow-up visit to an assisted-living facility rather than a patient’s visit to an emergency department.”

Little has been required in the way of groundwork. Doctors Making Housecalls met with facility representatives to explain the role and capabilities of advanced-practice paramedics, and just prior to rollout, assuming the data holds up, medics will visit each facility to explain what staff should and shouldn’t call for.

“Certainly, if a patient has an obvious injury or some other complaint, we want them to go through standard EMD,” says Myers. “I’m anticipating it’ll go very easily, because fall calls are basically already protocol-driven at these facilities. They’re already asking, ‘Does the patient have chest pain or shortness of breath?’ If they do, they’re already calling on those complaints. I’m thinking from a safety perspective it’s going to be just fine.”