Redmond ‘community paramedic’ a first for Oregon

Learning to live with a chronic condition can help prevent at risk people from developing even more serious health concerns.

Many people with diabetes, heart disease, lung disease and other conditions face barriers to good health management.

If they’re unable to travel to their doctor’s office or don’t understand how to properly take their medicine or measure their blood sugar or blood pressure, their conditions can spiral out of control.

Redmond Fire and Rescue’s mobile paramedic program plays an important role in the community health of Central Oregonians by helping high-risk patients avoid preventable health emergencies.

When Doug Kelly, Redmond Fire and Rescue EMS division chief, heard about mobile paramedic programs in Texas and Colorado, he was convinced such a program could make a difference for rural Oregonians.

Kelly worked with PacificSource Community Solutions, the coordinated care organization in Central Oregon, and St. Charles Health System to set up the state’s first grant-funded mobile paramedic program.

The program serves at-risk patients with high needs in Redmond and the rest of Deschutes, Jefferson and Crook counties by providing follow-up care in their own home.

It helps keep people with chronic conditions from making unnecessary and expensive ambulance trips to the hospital emergency room.

“Patients who participate in the program will have a better understanding of their illness and what it takes to get better,” Kelly says. “The key to what this program does is education. The goal is to help people better understand their disease.”

Dan Cox is the program’s man on the ground. A retired firefighter/paramedic, Cox is the community paramedic who works directly with the patients.

“My job is to help people better manage their health,” Cox says. “Often, I can see what the problem is when I get to their house.”

PacificSource works with its member providers to refer high-risk Medicaid patients to the program.

Only those who have been hospitalized with specific chronic conditions such as chronic obstructive pulmonary disease (COPD), heart disease or diabetes and are at risk of being re-admitted to the hospital are included.

If a referred patient meets the criteria, Cox gets a health history from their doctor and calls the patient to set up their first visit.

“Some people need help for just a few visits. Others need help for much longer, sometimes even months,” Cox says. “One man I worked with had hypertension, and his provider couldn’t figure out how to help him manage his pills. This patient continued to come back for care because he was mismanaging his medication.”

Cox realized the man’s medical condition was a barrier.

“He had suffered a stroke that damaged a portion of his brain and he couldn’t make sense of the directions on the pill bottle,” he says. “Every Monday, I would visit him and fill in his pill box and made sure he watched.

“Later on, I would have him practice while I supervised. Eventually he could do it all on his own and was successfully taking his medication without help. He just needed that extra attention to get him started.”

By focusing on this specific group of people, the community paramedics help them gain a better understanding of their illness and what it takes to get better. Many patients have access problems and don’t qualify for home health care. This program covers that gap.

“I see it as a success when I have graduated a patient from the program and know that they are able to manage their own care,” Cox says. “I get to do something not a lot of paramedics get to do, and that is pretty great.”

Read this story, and other inspiring stories about improving health for Oregonians, at http://www.oregonhealthstories.com/

(Article provided by Lauren Mulligan of the Oregon Health Authority)