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PSOW 2016 - Community Paramedicine in Wisconsin

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PSOW 2016 - Community Paramedicine in Wisconsin

Publicado en: Salud y medicina
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PSOW 2016 - Community Paramedicine in Wisconsin

  1. 1. COMMUNITY PARAMEDICINE IN WISCONSIN WHERE ARE WE AND WHERE ARE WE GOING?
  2. 2. Community Paramedic: Accountable Care Partners ●Viable option for improving the experience of care, improving the health of populations and reducing per capita costs of health care ● Bridge existing health care gaps, avoid duplication ● Reduce the cost of overall health care expenditures ● Reduce stress on vulnerable patients and improve care coordination ● Reduce hospital readmissions and emergency department utilization and avoid penalties
  3. 3. THE VALUE of CP in ACCOUNTABLE CARE Linking Primary Care & EMS Enabling Legislation, Credentialing Reimbursable CP Practitioner Services Identified Partnership Between Hospital and EMS or FD ED Utilization Complex Patients Without Services Patient Primary Care Plan, PCP Driven
  4. 4. COMMUNITY PARAMEDIC WORKFLOW
  5. 5. WHAT DOES SUCCESS LOOK LIKE?
  6. 6. NEW HANOVER REGIONAL – NORTH CAROLINA
  7. 7. ABBEYVILLE SOUTH CAROLINA COMMUNITY PARAMEDIC EVALUATION REPORT NOVEMBER 2015 ED UTILIZATION CP PATIENTS – 58.7% DECREASE VS. CONTROL – 4% INCREASE INPATIENT UTILIZATION CP PATIENTS – 60% DECREASE VS. CONTROL – 500% INCREASE ED CHARGES CP PATIENTS – $879 DECREASE VS. CONTROL – $126 DECREASE INPATIENT CHARGES CP PATIENTS – $1,249 DECREASE VS. CONTROL – $19,960 INCREASE
  8. 8. LEGISLATION IN WISCONSIN STAKEHOLDERS • PROFESSIONAL AMBULANCE ASSOCIATION OF WI - PAAW • PROFESSIONAL FIRE FIGHTERS OF WISCONSIN – PFFW • WISCONSIN EMS ASSOCIATION - WEMSA • WISCONSIN STATE FIRE CHIEFS ASSOCIATION – WSFCA
  9. 9. LEGISLATIVE PROCESS • Process started by PFFW and Rep. Katrina Shankland (D) Stevens Point • Bill drafted in late summer 2015 • Outreach to other medical groups: • WI Nurses Association • Medical Society of Wisconsin • Office of Rural Health • DHS
  10. 10. LEGISLATIVE PROCESS • Stakeholder phone conferences started by PAAW and archived at www.paaw.us • List serv started by Rural Health and archived at www.paaw.us • Stakeholder meeting in Stevens Point – summer 2015 • Support offered by Rep. Amy Loudenbeck (R) Clinton • Legislation session ended with bill in draft form
  11. 11. LEGISLATIVE PROCESS • All inclusive Stakeholder group reconvened May 2016 • New draft circulated July 2016 • General consensus across the board on issues
  12. 12. HIGHLIGHTS OF BILL DRAFT • Expands definition of EMT to add CP function to current definition • Actions and training to be authorized by DHS • Agreement with a hospital or physician • CP endorsement by DHS • CP must be part of ambulance provider or hospital • No Medicaid reimbursement in the bill
  13. 13. NEXT STEPS • Introduce vetted bill when legislative session opens • Build consensus across other disciplines • Reach out to local legislators to garner support • Establish discussions with local hospitals to forge partnerships for pilots and/or services • Work to increase training opportunities for certification
  14. 14. WISCONSIN PIONEERS • Green Bay Fire Department • Greenfield Fire Department • Madison Fire Department • Milwaukee Fire Department • Ryan Brothers Ambulance • West Allis Fire Department
  15. 15. MILWAUKEE FIRE DEPARTMENT COMMUNITY PARAMEDIC PROGRAM Captain Michael Wright NREMT-P CPMIH TEMS
  16. 16. PILOT PROGRAM RESULTS OCTOBER PATIENT 6 MTH PRE 6 MTH POST % CHANGE Hours of engagement DA 33.5 15 25 66.67 RB 17 2 4 100 CS 15.5 8 3 -62.5 MK 15 1 1 0 TB 15 3 0 -100 BL 12.5 2 0 -100 SR 38.5 10 1 -90 CH 17 9 1 -88.89 NS 17 4 2 -50 TOTALS 181 54 37 66.67 100 -62.5 0 -100 -100 -90 -88.89 -50 -150 -100 -50 0 50 100 150 1 October 2015 Pilot Data DA RB CS MK TB BL SR CH NS
  17. 17. PILOT PROGRAM RESULTS NOVEMBER PATIENT 6 MTH PRE 6 MTH POST% CHANGE Hours of engagement RG 14 9 0 -100 CS* 7.5 4 2 -50 DP 27 29 51 75 TW* 16 12 1 -92 JS 13 2 0 -100 GW 7.5 10 16 60 JA 16.5 4 1 -75 MB* 5 3 3 0 MM 13.5 14 9 -36 TOTALS 120 87 83 -100 -50 75 -92 -100 60 -75 0 -36 -150 -100 -50 0 50 100 1 November 2015 pilot data RG CS DP TW JS GL JA MB MM
  18. 18. PILOT PROGRAM RESULTS DECEMBER PATIENT 6 MTH PRE 6 MTH POST % CHANGE Hours of engagement RL 21 38 14 -63.15 JN 14.5 4 0 -100 HH 16.5 1 1 0 LL 22 14 0 -100 PG* 23 13 4 -69 DM* 15.5 21 15 -28.57 JJ* 4.5 21 7 -66.66 GT* 4.5 5 3 -40 MT* 4.5 6 0 -100 DT 21 6 7 14.28 TOTALS 126 123 51 *did not complete program -63.15 -100 0 -100 -69 -28.57 -66.66 -40 -100 14.28 -150 -100 -50 0 50 1 December Pilot data Series2 Series3 Series4 Series5 Series6 Series7 Series8 Series9 Series10 Series11

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