Individuals with multiple chronic conditions tend to experience increasingly fragmented care in the presence of additional behavioral health issues and social complexity (e.g., financial resource strain, history of traumatic adverse events, social isolation). Community Paramedicine (CPM) programs, leveraging trained paramedics and social workers, can play a significant role in breaking the resulting cycle of dysfunctional emergency department and hospital use among the “super-utilizing” patient population. The CPM program developed by Indianapolis Emergency Medicine Services has demonstrated decreases in short-term acute care utilization; however, benefits deemed important to patients are largely unknown. The purpose of this project is to develop a research collaborative that will ensure a patient-centered approach to CPM.
The first task will be to engage patients by listening to their experiences in getting their physical, behavioral, and/or health-related social needs met within the context of the local healthcare and social service delivery systems. From these discussion groups, patients will be recruited as peer advocates and empowered to share their stories and expertise within a collaborative environment.
The second task will focus on engaging patients in a multi-stakeholder community collaborative, facilitated by Q-source, Indiana’s regional Medicare Quality Innovation Network-Quality Improvement Organization. Multi-stakeholder meetings will be convened to (1) share multiple perspectives on breakdowns in care from patients, healthcare providers, and social-/community-based service providers in a respectful and thoughtful manner; (2) discuss CPM and related strategies for improving care; and (3) develop potential comparative effectiveness research questions related to how different models of post-discharge outreach improve care quality and coordination.