To help one local community improve patient outcomes, lower healthcare costs and provide more accessible care to chronically ill patients, southern Wisconsin-based Ryan Brothers Ambulance Service last June opened the Triangle Health & Resource Center, a community paramedic clinic staffed by EMTs, paramedics and CP students undergoing clinical training.
After a local television news segment last spring spotlighted the community paramedic concept, the managers of the Brittingham Apartments in Madison’s lower-income Triangle neighborhood approached the ambulance service about bringing in a CP to provide care for more than 600 of their residents.
“We were looking for an opportunity for our community paramedics to do clinicals and provide a community service,” explains Patrick Ryan, one of the owners of Ryan Brothers. “The managers of Brittingham contacted us about staffing a health clinic that was formerly staffed by parish nurses from a local hospital. We met with them and decided to give it a try. So far it is working well and appears it will be well into the future.”
The community paramedic model, now being replicated in communities across the country, is one way to help patients without having to check them into a hospital. Not only can it save patients potentially thousands of dollars in emergency room bills, but it can also help hospitals avoid financial penalties for preventable readmissions.
“Most patients are looking to have their vital signs monitored because they are on medication for high blood pressure or diabetes,” says Ryan. “Others come in for wound care or foot care as well as to have their toenails trimmed because they can no longer have it done elsewhere.”
For other EMS services that would like to create a similar model, Steve Zank, a Ryan Brothers community paramedic and the clinic’s manager, says being prepared to deal with patients who suffer from mental health problems is important.
“Most people we see do not have severe mental health issues,” says Zank. “They function well in society but just want to socialize and have someone address their concerns. As a community paramedic, you may have to sit and chat with someone for 15 minutes to a half-hour. It’s unlike an ambulance call, where you’re in and out in under 10 minutes. This is more of a hands-on experience.”
The clinic is open two days a week, Tuesdays and Thursdays, from 10 a.m.–2 p.m. Zank is on-site during those times. To date he estimates they have seen about 375 residents since the clinic’s opening. In addition to helping patients manage chronic conditions, Zank assists patients following surgeries so they can heal quickly and avoid a return trip to the emergency room.
Ryan adds that the clinic has been preventing emergency department visits and hospitalizations so far. If necessary, staff can refer patients to their in-home healthcare units or urge them to contact their primary care physician.
“One of the big emphases of our program is that this is a primary care-driven service, and if someone doesn’t have a physician, we will help find them one,” says Erin Ryan, Patrick’s brother and co-owner of Ryan Brothers. “If they have a physician and the physician doesn’t want us to see their patient, we’ll step back.”
Zank stresses that this model is not intended to take away anyone’s job. “We want to work with healthcare providers to improve outcomes for their patients and reduce readmissions and emergency room visits. This benefits the patients because it fills a gap when home health units may not be able to send someone to see the patient as often as the patient needs to be seen. Going into the future, this is what EMS will be about, and we hope to be a leader in the field.”
The clinic has proved to be so successful that this past fall, the ambulance service opened another clinic in a smaller lower-income neighborhood three miles away. That clinic is staffed on Monday afternoons from 1–3 and averages about four patients weekly.
“The managers from that complex saw what we were doing with Triangle Health and the success we’ve had,” says Erin Ryan. “They thought it would be a great thing to offer for their residents as well.”
Ryan Brothers does not charge for the services provided at either clinic, but rather sees the benefits as an opportunity for its community paramedics to perform clinicals, provide a community service and promote the community paramedic concept, notes Patrick Ryan.
“Wisconsin is in the process of adopting the community paramedic model, drafting legislation and establishing partnerships between EMS agencies and healthcare organizations,” he says. “This grassroots type of work is necessary as we work to replicate the outstanding work being done in other areas of the country, including by our neighbors in Minnesota.”
Daniel Casciato is a freelance writer and social media consultant from Pittsburgh, PA. He makes his living writing about health, law, social media and technology. Follow him on Twitter at @danielcasciato.