The evolution of community-based programs here is almost anthropological in nature. Community paramedicine or mobile integrated healthcare is evolving and forming according to local environmental and political conditions. No two programs are the same, which is technically good, as they are shaped to meet the needs of the population for which they are intended to serve. The bottom line for many of these programs to be successful and attain longevity is to be actuarially sound and generate income to be self sustaining.
Sadly many programs to date have operated on a loss leading footing and, unless sustainable income is forthcoming Â via legislative changes, some could fade as quickly as they initially shone. That said, some community-based activity is already part of normal daily EMS practice and could rightly be classed as “paramedic in the community” activity.
Understanding who your “frequent service users” are and managing their whole system use and creating case conferences is a great community activity. Â Fostering relationships with other local care organizations such as behavioral health, social services, faith-based groups and both the primary and secondary care sectors may lead to the creation of cost-effective and sustainable programs. Â This level of liaison also assists in the breaking of barriers and removal of care silos.