Holyoke EMS director Brady Ring, pictured at right, and community paramedic Lisa Werts are thrilled to have received the community paramedicine program licensure that has been in the works for 22 months. With a three-ring binder filled with the program protocal, Werts is ready to make a difference for the community. Ring is holding a Vital Vial that will not only be used in the program but is also available through any provider working through Melissa Memorial Hospital. — The Holyoke Enterprise | Johnson Publications
Holyoke EMS has been working on a community paramedicine program for 22 months. At long last, EMS director Brady Ring and community paramedic Lisa Werts are excited to announce that as of Jan. 2, the program is up and running.
Having obtained her community paramedic endorsement, effective over a year ago, Werts is ready to hit the ground running to put the community paramedicine program into action. Holyoke EMS received the facility license for the program last week, so “paramedicine is here,” said Ring.
What does this mean for locals?
As a community paramedic, Werts is certified to see patients in their homes, serving as a proxy for the local medical providers.
“We’re catching people who fall through the gap,” Werts said. Elderly residents and those who are either uninsured or underinsured can be hesitant about seeking medical help, but they can now be seen by Werts for earlier intervention.
If Werts can check on patients at an early stage or visit them if they have a medical issue, she can potentially save them from an ambulance ride and therefore higher expenses.
As an example, say a person needs a simple blood draw to diagnose an issue but can’t get to the hospital due to a storm. By waiting, medical issues escalate, perhaps requiring a more expensive emergency room visit and even a trip by ambulance.
Intervention by community paramedicine can make a huge difference.
Ultimately, Ring and Werts focus on the days of discomfort and its impact on the patient. Community paramedicine will allow Werts to serve as an advocate and navigator for patients and their health needs.
Patients must come to her through a referral process — from health care providers, social services, law enforcement, Centennial Mental Health, etc.
Werts’ work will be assessed by Dr. Rebecca Moore, who serves as medical director for this program. If there is no provider involved, Moore can assess the situation and give the referral for Werts’ services.
Community paramedicine is short-term — maybe one visit or up to two months for an issue.
As she sees people, Werts will be taking them a Vital Vial. This medicine vial includes such things as a list of current medications, advance orders, a magnetic “Do Not Resuscitate” piece to put on the refrigerator (if appropriate) and ID stickers to put on front and back windows of the house.
Anyone can ask for a Vital Vial from their local health care provider. To have this type of information readily available will be of great value to the community paramedic.
As this program starts, the main focus will be patients with chronic obstructive pulmonary disease, heart failure, diabetes and anticoagulant therapy. “Out of that, all kinds of things can rabbit trail off,” Werts said.
She is authorized to complete home safety assessments to look at helpful resources. This might include recommending handlebars in the bathroom or by the bed for those who often fall or identifying trip hazards in the home.
Werts can also take a basic emergency medical technician with her or an interpreter if there is a language barrier.
Initially, she will be using the big full-size ambulance rig as she makes community paramedicine calls. However, she and Ring said that eventually they hope to have a decent four-wheel-drive SUV to provide more discretion when they’re parked at people’s homes and also to allow better traction on bad roads.
Local program is No. 5 in Colorado
Holyoke EMS, through Melissa Memorial Hospital, is the fifth in the state to have a licensed community paramedicine program. And it’s by far the smallest agency of the five, said Ring.
The community paramedic endorsement earned by Werts is an add-on certificate to the paramedic. Only paramedics are eligible for the course, and right now two years’ experience as a paramedic are required to pursue the endorsement.
Her certification through the International Board of Specialty Certifications shows her to be No. 8 in Colorado and No. 155 nationwide to earn the community paramedic licensure.
Melissa Memorial Hospital Foundation covered Werts’ education and testing expenses through the Paramedic Scholarship Fund, founded in memory of Stan Willmon.
State to survey program annually
Accountability is keen in this program. Ring noted the State will survey them every year, looking at 100% of the documentation.
This is actually the third phase of overview. The patients’ providers will review the documentation, and Moore will look at 100% of Werts’ documentation, as well.
Additionally, the State will do a site visit at least once every six months.
“I like it,” said Werts. “It’s a little intimidating, but this is what we need to keep accountable. Our goal is success.” Ring concurred that it’s in their best interest to have the accountability checks.
Process started 22 months ago
Ring and Werts said that Holyoke EMS started looking into this community paramedicine program in March of 2018, and Ring hired Werts to get the program going.
Through a personal connection, Werts learned that the very first training class was starting in April, and she was on board. The online classes and on-site clinics led to November testing.
It was another three months before Werts learned that she passed the test, but her certification was retroactive to her November 2018 test date.
Eleven months ago, on Feb. 1, Ron Seedorf of the Colorado Rural Health Center and community paramedicine pioneers Christopher and Anne Montera of Eagle County were in Holyoke to review MMH’s progress toward establishing the program.
While the Monteras confirmed that Werts was on the right track with her outline of the Holyoke program, she also assisted them with some ideas of her own.
“We got to be part of it in a small way,” said Werts, of the formulated plan for community paramedicine.
Moving forward with the local program did not progress as rapidly as Werts and Ring had hoped.
The 22-month wait has made them extremely excited about moving forward.
Werts said it is also their goal to help support other agencies, to help them get licensure much more rapidly. In fact, the Colorado Rural Health Center wants Werts and Ring to assist other agencies with the pages of details that delayed the Holyoke process.
The duo is optimistic about the impact of community paramedicine, and they look forward to developing the program.