Franciscan Health Paramedicine Program in Crawfordsville Ready to Expand
In early 2018, the Community Paramedicine program – a partnership between Franciscan Health, the City of Crawfordsville, Montgomery County Health Department, Indiana State Department of Health, Montgomery County Community Foundation, Wabash College and the Women's Resource Center of Montgomery County – will expand from its current pilot program and begin accepting more patients.
Currently, the program is working with patients with heart failure and other chronic diseases. After additional details are finalized, Community Paramedicine will begin seeing patients with chronic diseases such as diabetes and COPD, as well as being able to provide prenatal care to moms-to-be and postpartum check-ups to new moms.
"Community paramedicine works great in a community our size because of our ability to connect to community resources and navigate people accordingly. There's a high level of trust in our community towards our firefighter/paramedics," said Paul Miller, EMS Division Chief for Crawfordsville Fire Department.
Crawfordsville Fire Department will have five community paramedics who will have completed their clinical rotations. In addition, those assigned to the prenatal and postpartum care visits will need to complete training in maternal/child health and work with the OBGYN staff from Franciscan Physician Network office in Crawfordsville and the Franciscan Health Center for Women and Children in Lafayette.
"Franciscan Health has had a huge impact on expanding the capabilities of the delivery system within the Crawfordsville Fire Department," continued Miller. "They've been able to develop training resources for us and financial mechanisms to put this into place."
Pilot Program Helps Patients and Their Families
Jim Derf is a retired science teacher from Veedersburg.
After retirement, he was having trouble working on his property.
He went to his doctor for my annual exam in August 2016, and during that visit, both the nurse and the doctor could not get a good pulse from my left arm. This led to all kinds of tests which discovered a 90% blockage in an artery in his left armpit. He was referred to Atul Chugh, MD, a cardiologist with Franciscan Physician Network Indiana Heart Physicians, who has an office in Crawfordsville.
"I needed some help. I had a quadruple bypass – even though there were six blockages. I hadn't recovered as fast as most people," said Derf. "The catheterization revealed two 90% blockages, three 80% blockages and one 50% blockage."
Derf was referred to the Community Paramedicine program, where he was assigned to John Toler, the community paramedic.
"When this program came in, it was perfect for me because I was recovering so slowly. The paramedicine program could answer my questions much better than a physician could because of the time factor," said Derf.
After receiving the referral, Toler called Derf to set up the initial appointments. He would drive to Veedersburg to meet with Derf and his wife Susanne and answer their questions. He was also given "homework" as part of the program – using a tablet to track various aspects of his health, including blood pressure, weight and other vital signs.
"By receiving these services, we are able to connect the patient to a primary care physician. We are also able to provide education to patients based on their healthcare needs," said Toler.
"For example, with heart failure patients, a 2- to 3-pound change in weight a day or a 5-pound change in weight can be an early finding that causes a readmission," said Toler.
In addition, Toler and the other community paramedics review medications, conduct a home safety inspection and provide a comprehensive health assessment.
"By connecting vulnerable patients who don't qualify for skilled nursing with Community Paramedicine, we stand the best chance of positively impacting their health and welfare," said Toler.
"It's so nice to be able to ask questions and to have someone such as a paramedic who could answer the questions that I needed answers to," said James.
In addition, the Derfs and Toler all developed friendships that go beyond just those visits.
"I don’t think I would have done this on my own. I needed someone pushing me and that was a big help," concluded Derf.
Small Program, Big Impact
It has taken about two years to construct the Community Paramedicine program, said Terry Klein, chief operating officer for Franciscan Health Crawfordsville. During those two years, many healthcare officials have taken note of what is happening in Montgomery County.
And thanks to collaboration, the group has received grants and support from the Indiana State Department of Health, the Indiana Rural Health Association, the Montgomery County Community Foundation and the Centers for Disease Control and Prevention.
The group recently hosted and organized the 2017 Indiana State Health Summit on Community Paramedicine at Wabash College in October. There were more than 100 participants.
In addition, Miller and Jess Corbin, MSN, RN, director of care management for Franciscan Health, recently presented at UCLA's Prehospital Care Forum in Las Vegas, held in conjunction with the World EMS Expo. The program was recognized as a best practice model at the conference. The Community Paramedicine heart failure program received an award for Best Informational Poster Presentation.
"We know we are having an impact," said Miller. "We hear it from the patients."
Patients will need to have a referral from a physician or healthcare provider to the Community Paramedicine program. For more information, please call Hayley Kaelin, Community Paramedicine Coordinator with the Franciscan ACO, at (765) 364-3199, or visit franciscanhealth.org/paramedicine.
By Matt Oates
Marketing and Public Relations