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Community Paramedicine Clinical Trial Launches in Canada

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January 7, 2015 -- Grey County, in partnership with the Owen Sound Family Health Team and St. Michael’s Hospital (Rescu), has officially launched an “EPIC” new community paramedicine program. The one-year clinical trial will study the value of in‑home healthcare by paramedics in reducing emergency room visits and hospital admissions.

Expanding Paramedicine in the Community (EPIC) utilizes highly skilled community paramedics to monitor and treat patients in the comfort of their own home. In-home treatment can help prevent a condition from progressing to a point where a hospital visit is necessary.

“Too often patients with a chronic condition end up in the hospital or worse from symptoms that could be identified and treated by a community paramedic,” says Mike Muir, Director of Paramedic Services with Grey County. “Our community paramedics can save patients unnecessary suffering and trips to the emergency room by checking in regularly and catching symptoms early.”

Currently Grey County’s primary care paramedics act as first responders and are limited in what medications and treatments they are able to administer. Through the EPIC program, two paramedics have been reassigned and trained as community paramedics, a designation which greatly increases the treatments a paramedic can administer through consultation with a patient’s doctor.

EPIC focuses on patients diagnosed with the chronic conditions diabetes mellitus (DM), congestive heart failure (CHF), and chronic obstructive pulmonary disorder (COPD). These are three of the most common chronic conditions in the world. The trial will run for one year and is paid through one-time funding of $300,000 approved by the province this past September. Grey County Council supported the funding application in 2014.

“We were very pleased to learn our funding application had been approved and we could participate in this important study,” says Grey County Warden Kevin Eccles. “Healthcare is imperative to all residents in our community and it’s important to find innovative new ways to improve access to medical professionals and to reduce emergency room wait times.”

Leading the EPIC study in Ontario is St. Michael’s Hospital.

“There’s no high-quality evidence showing that, beyond the current system of care, community paramedicine provides an additional cost-effective care to elderly or chronic patients,” said Dr. Laurie Morrison, a scientist with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and the Director of the Rescu – a group studying out‑of‑hospital emergency healthcare. “EPIC will address this gap in science.”

Patients Needed for the Trial

The Owen Sound Family Health Team will work locally with Grey County paramedics to administer the trial. In total 200 voluntary patients are required. To qualify, individuals must be existing patients with the Owen Sound Family Health Team and be diagnosed with at least one of the chronic conditions mentioned above.

Qualifying patients have been sent a letter from the Family Health Team requesting participation in the study. Patients must complete and return the response card within two weeks to be eligible for the program.

“We encourage all qualifying patients to get their response cards in quickly as space in the trial is limited,” says Dr. Shiv Grewal of the Owen Sound Family Health Team. “Those participating in the trial will benefit from convenient in-home treatment by community paramedics working closely with their family doctor.”

The program also benefits patients without access to transportation finding it difficult or impossible to attend regular appointments.

Data will be collected confidentially throughout the study and analyzed by a third party. Results will be used to help determine the effectiveness of community paramedicine.

Training Our Community Paramedics

Grey County Paramedic Services is drawing on the experience and expertise of two long-time paramedics to fulfil the community paramedic roles for the year. Veteran primary care paramedics Rick Trombley and Scott Luce have been reassigned to the position from an elite group of applicants.

“A primary care paramedic shows up when a disease has progressed to a point where a patient needs immediate medical attention and ends up in the hospital,” explains Trombley about the difference in paramedic roles. “On the other hand, a community paramedic enters the picture much earlier and acts as an intervener by reporting the patient’s conditions to their family doctor early on and providing the recommended treatments.” Trombley points out community paramedics have the training needed to administer some of the same medications a patient would traditionally only receive at the hospital by a doctor.

Community paramedics also have the unique opportunity to observe patients in their home setting to learn more about their lifestyle and habits and to help educate them in ways to better manage their disease.

To prepare for their new role Trombley and Luce completed an intense training course through Centennial College. The course involved online, classroom and in‑field learning as the pair was able to ride along with York Region community paramedics on the job. York has been conducting a paramedicine trial since 2013 with positive results.

“I’m really looking forward to building relationships with patients and providing better care to prevent avoidable pain and trips to the emergency room,” said Luce when asked what he’s looking forward to in his new role. “This trial is taking the paramedic role in a new direction and it’s very exciting to be involved.”

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