To relieve pressure on overwhelmed emergency rooms and to better serve patients, Lee County is expanding its paramedicine program.
EMTs are now providing at-home care to more patients when it's feasible, instead of transporting them to ERs.
On WGCU-TV's "Southwest Florida In Focus," Host Sandra Viktorova spoke with Lee County Public Safety Medical Director Dr. Jim Augustine about how this on-site care is reducing the need for more ambulance trips to the hospital.
"I find this program fascinating," Viktorova said. "Why give paramedics, EMTs, these new duties? How is this going to help?"
"This helps the community by delivering care to people who need care in something other than the back of an ambulance, an emergency department, or an urgent care center," Dr. Augustine said.
"And for our paramedics and EMTs who work on the streets, this is a way of them delivering much better care than they can deliver by, one time after another, coming to see somebody with red lights and sirens on."
"So let's talk about the patients you're really focusing on," said Viktorova.
"We started this program as a pilot about eight months ago, with some of our opiate recovery funds for the state, in an attempt to reduce the number of overdoses and fatalities and people with issues that would lead them to overdose in the field," Dr. Augustie said.
"So that case you were talking about was the settlement with the pharmaceutical companies," said Viktorova.
"It was the opiate settlement funds, that came into the state of Florida. And they were funding programs like ours across the state. And those programs have come to reduce the number of overdose deaths. And the people who have those recurrent situations found a much better way of caring for those people," Dr. Augustine said.
"We're implementing the programs that have been implemented in other parts of the state and the country to reduce that impact on our community."
"And there's a wide variety of patients that you're really targeting. Seniors who've had hip fractures, cardiac patients. Tell me about those," said Viktorova.
"We have an opportunity now in partnership with Lee Health to expand this program and to deliver care to people who are identified at the hospital level as having needs that may not be well met by them simply going home and having an occasional visiting nurse come to see them," said Augustine.
"The hospital can call us, let us know those patients are going home, that they're frail, that they have needs that may not be matched well again by having them coming back in the emergency department, or having an attempt at having physical therapy or other services at home."
"We send a crew to the house, figure out what their needs are, begin to address those needs at home. In some cases, getting them aligned with, palliative care or hospice. In some cases, finding better home health care services that match their needs. And we can do that across our entire community, which sometimes isn't easy for the hospital-based care to do."
"I assume you would argue this makes financial sense, and that there's proof that this type of program works, right?," Viktorova asked.
"Yes. And actually the experience from both across the country and the experience I've had in other cities, this makes financial sense by reducing the number of patients in our medic units. Reducing the number of patients going to the emergency department, and keeping these people's bills from getting higher and higher when they're already identified as having problems related to their heart, or their diabetes or their hypertension, or their COPD," said Augustine.
"Because in the end, if they're indigent patients, that bill sort of comes back to the community in many ways," she said.
"Yes, it does, but many of these patients have some insurance. But that's still a cost to everybody in the system when those patients can't find the right care," he said.
"And of course, we have a certain burden here in this area because we have a lot of visitors who are only here part time. Sometimes they come down here not so healthy, and they think that Florida sunshine alone will get them better, and they begin to have their problems, and then they're back in the emergency department again and back to their hotel or home."
"We are shortcutting that by saying, if we've identified that they need care, we know the system really well. We have EMTs and paramedics who know the system really well. Let's find them the right care and keep them in their home. Keep them in their hotel. Keep them plugged into the system at the best site of care for the least cost," said Dr. Augustine.
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