We are passionate about thoughtful, effective medical care, especially new models that work in complex situations. That's why we are big supporters of WOCNs. It's why we love these Long Term Care programs. And it's why we started ClickCare.

As we all know, long term care and care for chronic conditions is only increasing as a percentage of the total medical field. So solutions that don't treat chronic problems as acute but rather treat them as the holistic, long-term conditions that they are -- have a lot of potential to be transformative.

A new example of this kind of out-of-the-box thinking caught our eye recently, for just these reasons. It's a model called Community Paramedics or "mobile integrated health care." The model is structured to avoid frequent trips to the emergency room by folks who could be better treated at home. So when an emergency call is made, and paramedics respond, the paramedics are trained to connect with physicians via tools like videoconferencing on an as-needed basis. That usually means additional training, a team approach, and an emphasis on preventing unnecessary transport.

The New York Times quotes Dr. Karen Abrashkin, one of the leads in a Community Paramedics program, as saying, “A lot of what’s been done in the E.R. can safely and effectively be done in the home... the hospital is not always the safest or best place to be.” So the Community Paramedics programs focus on treating patients with at-home visits by paramedics, avoiding E.R. visits.

The justification is pretty simple. Emergency rooms often lead to readmissions, increased length of stay, deconditioning, rehab and physical therapy to regain mobility, hospital-acquired infections, and delirium. These things are true with most populations, but especially true for patients with complex problems or those who can be treated/triaged instead of becoming super-utilizers of emergency rooms. 

For the patients, the consequences of this kind of emergency room visit can be deadly or contribute to a decreased quality of life. Of course, on "another side of the table", these issues also put hospitals -- especially in a pay for performance system -- under huge amounts of financial pressure.

Community Paramedics challenge the typical thinking of "we need to do this just to be safe." But "just to be safe" can kill. So we think this kind of thoughtful approach could be hugely impactful as a model. 

We would argue that videoconferencing in these situations is ultimately not the best way to go, since it necessitates physicians to be immediately available, makes the flow of treatment with the patient more challenging, and cannot be used later as a teaching case. We believe that especially when you are working with teams across the continuum of care, it's really important that consults can be done asynchronously using a healthcare collaboration tool like hybrid store-and-forward telemedicine.

It makes financial sense and it keeps people in their homes, healthy and mobile, longer.

Learn more about how healthcare collaboration tools can support innovative models like this one: