Governments and Regional Health Authorities appear to be holding the line on spending. Manitoba's emergency medical services system isn't likely to see any additional funding in 2009/10. No surprise really, in light of our current economic climate. But as the demand for health care continues to rise, can we afford to sit back and wait for an upturn in our economy? Or is now the time to consider investing in health care...in changes that could ultimately improve service and may even reduce costs in some areas?
For a number of years, paramedics in Nova Scotia (Long and Brier Island) and Ontario (Beausoleil First Nation on Lake Huron’s Christian Island) have had "expanded roles" within their respective community health care systems. These programs involve paramedics providing primary health-care and prevention services in addition to handling their normal emergency call volume. They visit patients in their homes and provide routine services ranging from checking vital signs and general patient assessment to administering flu shots and assessing medication compliance. They conduct home assessments to detect fall hazards and other dangers. By developing collaborative relationships with local home-health services, they have also begun to perform home wound care, draw blood to ensure people who require routine blood work actually have it done, and assist with medication administration.
Health care models that incorporate paramedics in expanded practice roles have proven successful. Programs such as these have significantly reduced hospitalizations, visits to physician offices and emergency departments, and residents’ travel times and costs. In one such example, an elderly couple was transported by ambulance six times in six months, although none of those transports resulted in a hospital admission. Following the commencement of daily visits by local paramedics, they haven't been transported once.
Paramedics have also seen their roles expanded in larger urban centers. Cities such as Ottawa and Edmonton have used paramedics to assist with patient care and treatment in crowded emergency rooms. Paramedics in Saskatoon have been used to assist in the provision of mobile health services in neighborhood communities, targeting children, the elderly, immigrants and individuals with chronic disease. And examples of community paramedicine have captured the attention of rural health leaders in other Canadian jurisdictions as well. Most recently, the role of Renfrew County paramedics has been expanded to include home visits and community patient assessments.
Expanded roles for paramedics increases accessibility of health services and has a positive impact on community health. It can reduce the demand on our emergency room facilities and resources. It seems promising for filling the widening health-care gaps in rural and remote communities. And it can reduces costs to our health care system and the public. Even in difficult financial times, it would be a very wise investment.
