Aging in place is easier for the elderly, their caregivers and their clinicians, and community paramedicine makes it possible. The Northwell Health service offers homebound people an alternative to calling 911 for help, often in non-emergent conditions.
"We started providing community paramedicine in 2013, well ahead of the trend," said Karen Abrashkin, MD, medical director of the health system's Clinical Call Center. She is also an internist in House Calls, Northwell's home-based primary care service that provides emergency care to enrolled patients. House Calls also dispatches community paramedics, who determine whether it's best to provide treatment at home or transportation for emergency services.
"Support from many areas of the health system is crucial to helping these patients," Dr. Abrashkin said.
Most House Calls participants have discussed their treatment goals with their physicians, and about 90 percent have established a medical order about life-sustaining treatment.
"We've broken down the silos that separate the nurses, paramedics and internists who function as primary care providers for patients in this program," Dr. Abrashkin said. "All parties collaborate seamlessly to honor a patient's goals of care, keep them where they want to be, and give them timely and appropriate medical treatment."
House Calls follows up with patients to assess symptoms after a community paramedicine response.