Baltimore’s paramedics will get an opportunity to make a difference in the field as they work with the University of Maryland Medical Center in a pilot program to reduce health disparities in west Baltimore.
The Mobile Integrated Health – Community Paramedicine program allows specially trained paramedics and nurses with the Baltimore Fire Department to treat some patients at the scene of a 911 call rather than taking them to the hospital. It also allows them to help patients transition back to their homes after a stay in the hospital.
“When I was a paramedic, one of the toughest things we had to deal with was I felt like we were part of an assembly line where we just grabbed the patients, moved them to the hospital, went back in service,” Niles Ford, the city fire chief, said. “Where we are now and the direction we are moving in now, gives us a significant opportunity to make a difference out in the field.”
The pilot program has been funded by a $4 million grant from the Health Services Cost Review Commission. The funding is expected to last about four years.
Health disparities and improving health care outside of the hospital have become a focus for Maryland’s health systems as they try to drive down the costs of hospital admissions and readmissions.
University of Maryland Medical Center hopes this program helps to reduce some those disparities.
“Social and economic factors and the lack of a robust primary care infrastructure contribute to a high rate of health care utilization and … high EMS emergency responses,” Dr. David Marcozzi, assistant chief medical officer for acute care at the hospital, said.
About 10 percent of a person’s health care actually involves the health care delivery system, he said. Social and behavioral factors can be more significant and include things like food security, transportation and managing medications.
One aspect of the integrated program aims to help patients leaving the hospital transition to being at home, hopefully reducing the need for a readmission. The Transitional Health Support program includes a team of paramedics, nurses and physicians to deliver in-home, follow-up care and assist with chronic disease management for 30 days after a patient has been discharged from the hospital.
The program includes staffing for an operational command center with people from the the University of Maryland, Baltimore, the fire department and the hospital. The university hopes to add help from its School of Law and School of Dentistry.
Already the program has seen some success in reducing readmissions for patients in the program by 21 percent, according to data provided by the program. The data also shows an increase in the use of outpatient services.
The second part of the program, the Minor Definitive Care Now program, treats patients before they ever have to go to the hospital.
About 80 percent of Baltimore’s more than 154,000 calls to 911 every year are for EMS services. About 32 percent of those calls could be treated outside of the hospital, the fire department estimates.
To help handle some of these calls, the program has specially outfitted SUV that handles what look like calls that will not require patients to be transported to the hospital. They can treat the patient at the scene and the vehicle even comes outfitted with computers and printers so the patient can get a prescription, receive follow-up care instructions and have the information added to their electronic health record.
Right now the program is limited to west Baltimore, but the city hopes it can expand citywide.
“I believe in mobility. I believe in taking services to people,” Mayor Catherine Pugh said. “Even with health care so many of the people standing on the corners of our streets won’t come to you. We have to go to them.”