The Return of the House Call

Hospitals use telemedicine platforms in normal, profit-driven ways as do other providers. Follow up care, virtual appointments, and multiple provider collaborations, are examples. An innovative practice called community paramedicine involves utilizing paramedics and emergency medical technicians (EMTs) for in-home care. Traditionally, EMTs show up once they are called and transport the patient to the hospital for care. Now, in-home care can be provided by trained EMTs once called, or EMTs can make scheduled home visits, a new version of house calls.

The target populations include “frequent flyers” - those who are chronically ill and often end up in emergency rooms for treatment that could be done in their own homes. Trained EMTs can engage the patients and their primary care physicians onsite, if warranted, without having to transport them.

Other likely participants are post-op patients and those recently released from hospital care. EMTs can monitor conditions, check vitals, and educate and review providers’ instructions and medication schedules.

In-home services can include wound care, condition monitoring, chronic disease management, medication usage, simple symptom checking, some vaccines, and fall prevention education. In the scheduled case, primary care providers refer patients once a program is set up, and in both cases, EMTs report back to the current provider. TruClinic sees its clients using its telemedicine platform in both cases.

There are two difficulties with the program, one is providing increased training and retention of trained EMTS. Emergency calls continue to increase and so does EMT turnover. New training programs and increased licensure requirements are solutions.

The other issue is no reimbursement is available for paramedicine currently. Using a long term view, this is a cost saver for hospital systems because it is proactive and preventative medicine. Treating patients in-home is much more cost effective than transporting and then treating them in emergency rooms. Patients appreciate being treated onsite in the convenience of their own homes without having to be transported, incurring additional cost and paperwork, and obtaining return transportation. Ambulance rides are only one way.

Community paramedicine is one more option hospitals can utilize telemedicine outside traditional ways. It’s a passive and innovative use to create partnerships and drive more mission-based benefits not only for the hospitals, but for the communities they serve. In the long term, it prioritizes assets and saves hospitals money, all while improving patient care.