When Keith Bailey retired three years ago as a Houston paramedic, the 55-year-old was ready to give up adrenaline-filled days rushing to car accidents, fires and similar emergencies. However, Bailey wasn’t quite ready to give up giving back to his community. So last year, he joined MedArrive and now spends his days performing routine medical exams and providing basic care to patients in their homes.
“You never know what is going to be going on the other side of the door until you get in there and kind of assess it,” Bailey told McKnight’s Home Care Daily Pulse. “If we have someone with high blood pressure, we may see that they are out of their medicine so we’ll need to get that addressed.”
Paramedics and emergency medical technicians are the backbone of MedArrive, a two-year-old care management platform that enables healthcare providers and payers to extend care into the home. MedArrive uses more than 50,000 EMTs and paramedics nationwide to provide in-home episodic and longitudinal care to patients who have chronic conditions and may be frequent users of emergency departments.
CEO Dan Trigub, a former Uber Health executive, launched MedArrive with EMTs and paramedics in mind. He calls them the most underutilized resource in healthcare at a time when there is a critical shortage of care providers.
“They are cost-effective and they are everywhere,” Trigub told McKnight’s Home Care Daily Pulse. “They are in rural communities and large metropolitan areas and they are a highly skilled workforce. In their day jobs they don’t normally practice their whole scope of training.”
Super skill set
Both EMTs and paramedics can perform basic medical tasks and make assessments regarding blood pressure, heart rate and breathing. They can perform cardiopulmonary resuscitation (CPR), bandage wounds and deliver oxygen. Paramedics are also certified to perform more advanced life saving procedures such as drug administration and manual defibrillation.
MedArrive isn’t alone in seeing the value of the nation’s vast network of EMTs and paramedics. Boston-based Medically Home, which offers turnkey hospital-at-home solutions to a variety of medical systems, is also using EMTs and paramedics. Medically Home Co-founder and CEO Rami Karjian told McKnight’s Home Care Daily Pulse that using paramedics is crucial to the company’s business model because it lets clinicians direct hands-on care from a command center often hundreds of miles away.
“It used to be that if you wanted to treat a patient in Kansas for hospital level care, the physician and the nurse had to be in Kansas,” Karjian explained. “Now Mayo [Clinic] is using doctors and nurses in Jacksonville, [Florida] combined with paramedics in Wisconsin to treat a patient in Wisconsin. So, you are evening out geographic disparities in the capacity where great physicians and nurses exist.”
Acute care niche
Medically Home contracts with Global Medical Response, which provides EMTs and paramedics for emergency care throughout the country. Some of the paramedics providing care work for Medically Home during their days off, but GMR Chief Medical Officer Ed Racht, MD, told McKnight’s Home Care Daily Pulse a growing number of paramedics and EMTs are interested in providing hospital-at-home and non-emergency care.
“This is a new career pathway and it’s a pathway for those who want a more in-depth, different approach to managing a patient population than maybe historically they’ve done,” Racht said.
While the use of paramedics and EMTs could be one answer to the healthcare worker shortage, both Karjian and Racht said regulations in many states must be updated before they can be used more widely. Some states only allow paramedics and EMTs to stabilize patients at home, before transporting them to hospitals. But Karjian says that is starting to change as states like Arizona and Wisconsin have revamped their regulations allowing teams to provide home healthcare.
“States see the power of having the paramedic in conjunction with having the x-ray tech, the nurse, the PT and OT all being able to treat the patient in the home,” he said.