Abstract
Background: There is a growing need for the expansion of the scope of practice in healthcare professionals worldwide. Canadian provinces such as Ontario, have piloted community-based projects involving the introduction of remote healthcare monitoring services. In August 2022, the Community Paramedicine Remote Care Monitoring (CPRPM) Program was launched in a relatively rural county – Oxford County, Ontario – by the community paramedic program in partnership with the Oxford Ontario Health Team (OHT).
Objectives: To evaluate the performance of the CPRPM program during the first eight months of its launch with regards to; a) improving patient outcomes, b) reducing hospital emergency department (ED) visits or 911-call frequency, and c) enhancing overall healthcare efficiency.
Intervention: This paper describes the impact of the CPRPM program through an interim performance evaluation report. The program was launched for residents at high risk of hospitalization due to exacerbations related to congestive heart failure, coronary obstructive pulmonary disease, diabetes, hypertension, or who frequently contacted 911-calls for ED visits in the past year. Referrals of patients were through the Emergency Medical Services 911-calls data and health care providers. Patients in this 90-day program were provided self-management education and medical kits for chronic disease monitoring. The program also included in-person visits and 24/7 availability by the paramedics. Patients participated in monthly Experience Surveys. There are three domains of impact discussed in this evaluation report, which are the impact of the CPRPM program on 1) 911 activations, 2) ED visits, and 3) patient satisfaction. The pre-post design was used to compare between the average 911 activations and ED visits before and after program implementation. The paired t-test analysis was used for statistical analysis.
Results: There were 133 patients enrolled in the CPRPM program between August 2022 and March 2023, 53% of which were female. The average age was 77 and ranged from 22 to 98 years. Preliminary findings show a potential positive effect of the program in the reduction of number of 911-call activation and ED visits. Patients were mainly satisfied or very satisfied with the CPRPM program experience (96%). The analysis is in progress and the findings will be presented for the conference in April.
Conclusion: This pilot program is unique in remotely monitoring patients at high risk of hospitalization in Oxford, Ontario; a relatively low population density county in Ontario, Canada. Early evidence suggests that this novel program is having the intended impact in efficiently enhancing the reduction of complications and potentially preventing medical emergencies.
Impact: This program helps in integrating and expanding the workforce scope of practice of paramedics in healthcare. It empowers patients as partners in adhering to treatment plans and leading healthier lifestyles. Finally, it improves accessibility and enhances healthcare equity by helping populations in need regardless of rurality of residence.