A health initiative has its “heart” directed at people who chronically visit emergency rooms to receive medical care.
The Rural Health Innovation Collaborative and Terre Haute Fire Department announced the pilot program at Union Hospital on Friday, sharing the intention to reduce medical emergencies in the community at no additional cost to the city, community or patients.
Called Helping Educate Area Residents Today — HEART — for Healthier Communities Tomorrow, the program aims to help people before they make a trip to the emergency room.
“We looked at the utilization of 911 services during a 10-month period, and found 47 patients who had made a total of 1,000 visits to the ER in 10 months,” said Stephanie Law, RHIC executive director, noting that few of those visits required emergency medical care. “They were accessing health care in a fashion that makes it available to them.”
But that was not cost-efficient for either health care providers or patients. With the average ER visit costing $2,000 to $4,000 and the basic EMS transport by THFD costing $550, those visits added up to millions of dollars.
“It made financial sense to keep these people in their homes,” Law said, “because we knew a percentage of the visits could be avoided. But, culturally, this is how they have accessed their health care.”
THFD Deputy Chief Glen Hall said that two firefighter paramedics will be certified to deal with “preventable emergencies” by making home visits to address issues being seen by emergency personnel. For example, that could mean talking to a diabetic person about better eating habits, when or how to better take medications, or what community or social services are available to help that person.
Firefighter paramedic Jaime Kempf and assistant chief Robert Eberhardt are going through the training.
“It is heartbreaking — but not uncommon — to respond to a 911 call and immediately see that the emergency could have been avoided completely,” Kempf said.
“Whether it is responding to a serious fall in the elderly and realizing that basic fall-prevention measures were not present in the home — or responding to a medical emergency caused by a medication mix-up or confusion over the types of foods that could worsen the person’s chronic condition, many times a small amount of additional information or support can make the difference between being healthy at home — or being rushed to the hospital with a painful or life-threatening condition.”
THFD Fire Chief Jeff Fisher said the program also allows trained personnel to look for hazards in the patients’ homes, such as overloaded electrical outlets or no smoke detectors or rocking chairs on extension cords.
Fisher said he worked on an ambulance for several years, and he is surprised that this type of program was not started sooner, because EMS personnel often have patients who regularly call 911 for transport on non-emergency issues.
Engaging with those people could take a burden off the community response, Mayor Duke Bennett agreed, as well as helping those folks improve their safety at home and quality of life.
Union Hospital CEO Steve Holman said that the pilot program has the potential of preventing a medical crisis from occurring for the patients. The hospital regularly sees more than 50,000 visits annually to its emergency room.
Union Chief Medical Officer Dr. John Bollinger said the program is taking care “out to the community, out to the patient. There’s a lot of need for that.”
Law noted that the group has also put together a policy paper and submitted it for consideration to the state about community paramedicine, because there are no state regulations on training or services.