Canada could provide a roadmap for the United States as it moves more healthcare into the home. The nation to the north is increasingly using paramedics and emergency medical technicians (EMTs) to deliver everything from primary care to palliative care into the homes of patients.
In a webinar Thursday sponsored by the World Hospital at Home Community, the director of emergency services for Renfrew County, Ontario, said mobile integrated healthcare (MIH) programs, which send EMTs into patients’ homes and are supplemented with telehealth, have been successful. Michael Nolan estimated MIH programs are saving $5 in healthcare costs for every $1 spent ramping them up.
“If you are going to invest $1 million into your local system for MIH activities, your system at a minimum will save $5 million,” Nolan said during the webinar.
Canada also is expanding the use of EMTs to palliative care. In 2018, Healthcare Excellence Canada, a nonprofit focused on providing at-home care to older adults, partnered with Canadian Partnership Against Cancer on a four-year palliative care program. Approximately 6,000 paramedics were trained to deliver palliative care to seniors across six provinces. The program resulted in an 80% decrease in palliative care patients going to the hospital for treatment.
“We are embedded in many palliative care teams now, such that we either provide an extension of that team, especially around pain management and calming the situation, but also being able to manage that patient’s experience and the family’s experience in providing a calm, peaceful and predictable palliative experience,” Nolan said.
Using EMTs for nonemergency care is not a completely foreign concept in the U.S. Some hospital-at-home programs, as well as in-home care platform MedArrive, have been using them for a couple of years. But demand for EMTs and paramedics could increase dramatically as an estimated $265 billion in healthcare services is expected to shift to the home by 2025, per a recent report by McKinsey & Company.
Paramedics and EMTs could help fill that demand as the nation struggles to fill roughly 7 million direct care jobs by the end of the decade, according to Gerad Troutman, MD, national medical director at Innovative Practices.
“The great thing about using these types of providers is they are acute care clinicians, so they can jump to the need and recognize when a patient is deteriorating,” Troutman said during the webinar.
