Ontario EMS expansion mirrors York Region program

Newmarket Era
January 22, 2014
By Chris Traber

York Region EMS chief and general manager Norm Barrette was on hand yesterday when Health and Long-Term Care Minister Deb Matthews announced a $6-million Ontario initiative his department got a head start on.

With the unveiling of new funds and support for community paramedicine programs, no one could fault the man who leads one of the province’s largest EMS units had he smiled and thought to himself, “Been there, doing that”.

However, smug is not his style.

Still, one could argue a pioneering York Region EMS pilot project is already a year ahead of the government’s plan to improve access to home care and community support services for senior citizens and other patients with chronic conditions.

“In many ways, we’re ahead of the curve,” Mr. Barrette said of expanding paramedicine in the community, a one-year pilot with a focus on specially trained York Region EMS personnel helping residents with complex medical issues such as diabetes, chronic obstructive pulmonary disease and congestive heart failure.

Such patients are fairly frequent EMS users and the pilot allows paramedics to provide in-home visits to assess blood pressure, perform blood tests and administer medications in consultation with a physician.

The project’s aim is to determine if the new approach results in fewer transports to hospital.

Ontario’s new plan calls for paramedics to apply their training and skills beyond the traditional role of emergency response and can include providing home visits to seniors known to call emergency services frequently and a range of other services, such as ensuring patients are taking their medications as prescribed.

Additionally, EMS professionals will educate seniors in their homes about chronic disease management, help connect them to local supports, such as diabetes education teams and refer them to their local community care access centre so they can be provided with appropriate home care services.

York Region’s pilot program mirrors Ontario’s proposed plan and shares the same objectives.

The region’s trial run will determine if EMS can help keep patients healthy and out of the hospital, Mr. Barrette said.

The pilot is part of the 10-year master plan approved by regional council.

The impetus for the new pilot project grew out of recognition the region is growing and aging.

By 2031, the population of York Region is projected to be about 1.5 million and, of that figure, about 310,000 will be seniors.

In 2011, people aged 65 and older accounted for 35 per cent of all calls to 911.

Beyond that, the demand for EMS assistance is expected to increase by 50 per cent over the next decade. As such, it makes sense to evaluate the current health care delivery structure to see if there’s a way to do things more effectively and efficiently.

This project has the potential to reduce emergency calls, emergency department visits, hospitalizations, demand for long-term care beds and ultimately, increase patient satisfaction.

The program is meant to support the provincial health care action plan and was developed in partnership with the Health for All team, Centennial College and Rescu, the emergency medicine research unit at St. Michael’s Hospital.

In the past, paramedics were perceived largely as emergency transport providers.

Best practices and innovation are transforming EMS professionals into paramedicine specialists and mobile health care clinicians prepared to help in-home.

“Over the last few years, we have witnessed the ability of community paramedicine programs in Ontario and beyond to leverage the talent of skilled paramedics to deliver better patient and system outcomes,” Ontario’s seniors strategy and Mount Sinai and the University Health Network hospitals geriatrics director Dr. Samir Sinha said. “Today’s landmark investment in community paramedicine will allow us to become a world leader in developing a variety of unique, made-in-Ontario solutions that help us to further deliver the right care, in the right place, at the right time.

“This is a great day for older Ontarians and especially those wishing to age in place in our rural and northern communities.”

Mr. Barrette said his department is likely to apply for participation in the provincial program.

Details on expectations, how funds will be allocated and how applications will be evaluated are forthcoming from the ministry.

A full report on the pilot will be presented to regional council by autumn, Mr. Barrette said.