Block EMS delivers very early intervention reliably and creates a distribution template on which to build out community health services in cities
Let’s look at some of the needed adjustments in deployment and dispatching that are required, with their possible impact and implications.
Then we can follow this up with an actual block count in a representative city (Vancouver) and discuss further pilots to establish that it’s all good – highest quality care, delighted patients, and budget-neutral. Our profit will be community health.
Some Direct Savings
- Moving some ambulance paramedics into the field. Each ambulance in this zone has one driver-paramedic, the usual second paramedic now works onsite in high-pop areas.
- Reducing or eliminating fire crew dispatching for medical calls. Displaced firefighting paramedics can be retained by the ambulance service.
- Reducing unwarranted transports to ED. The onsite paramedics triage all block calls, to intercept requests for ambulance service that can be dealt with otherwise.
- Reducing the ambulance infrastructure to reflect controls on unwarranted calls and less demand for transport, when onsite intervention exists.
- Reducing dispatching of ALS ambulances for non-acute calls.
- Reducing patient and/or personnel injury associated with accidents during hot dispatches or unwarranted transports.
Some Indirect Savings
- Reducing the severity of injury, permanent damage or premature death that can accompany late patient intervention, and result in lifetime burdens on all parties.
- Enfranchising community health and clinics through educating and referring residents and workers to them.
- Providing EMS infrastructure to community paramedicine that does not have to duplicate it for resuscitation, adverse event control, etc.
- Providing secure networking and technical expertise in telemedicine, remote patient monitoring, conferencing with physicians, etc. as alternatives which medical aides may not ordinarily access.
- Supplementing skills of a range of practitioners to allow them to deliver care more economically than fully trained career paramedics.
- Providing expanded scope for cardiac assessment and urgent treatments that medical directors may want to evaluate or incorporate.
The net healthcare cost to all stakeholders will be controlled, and the spectrum of treatments widened and strengthened, delivering a higher standard of care via integrated community health.