Ramiro Jervis, MD, SFHM
NSLIJ Advanced Illness Management
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
None
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 Off
hour & urgent
in person
assessments
limited
 Telephone
assessments
limited
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Only 1 RCT: 27% ED
use
 Programs varied in
implementation
 Scattered reports of
programs in the United
States
◦ ~40% utilization

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8
Kashif Baqai BS, CCEMT-P
David Kugler, MD
Elizabeth Quellhorst BFA, NREMT-P, CCEMTP, PNCCT, CMTE, EMD-Q
Jon. D. Washko, BS-EMSA, NREMT-P, AEMD
Thomas Kwiatkowski MD, FACEP
Kristofer Smith, MD
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House Calls Providers credentialed as
On Line Medical Control (OLMC)
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House Calls Providers credentialed as
On Line Medical Control (OLMC)
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Advanced Care
Paramedics
 Supplemental Instruction
◦ Geriatric assessment
◦ Advance Care Planning
◦ Clinical Rotation

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


Shortness of
breath~47%
Change in mental
status ~23%
Other ~30%
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
Since October 2013
◦ 1158 calls routed
through EMS Call
Center
◦ 120 Community
Paramedic responses
◦ 23 transports to ED
(19%)
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Chart review of 42
Community Paramedicine
Responses
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911 vs Call Center
Initiated Transport
250
200
150
14%
13%
17%
19%
13%
100
50
0
Q1 2013
Q2 2013
Q3 2013
Q4 2013
Q1 2014
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©AAHCM