Latest Thinking

Someone to watch over me

November 14, 2018

Chris Michel’s job has changed dramatically over the last three years. A longtime paramedic in Boston Bar, B.C., Michel recently became a community paramedic (CP).

While his colleague responds to most emergency calls around this small town on the steep side of the Fraser Canyon, Michel is focused on helping the area’s 1,000 residents stay healthy—and avoid having to call 911.

“My daily work as a CP is all about promoting health,” says Michel. “I visit and monitor at-risk patients. I hold health seminars and disease-specific workshops. I help people learn more about their conditions and how to self-manage their health. It’s fascinating, rewarding work.”

And it’s making a big difference in this community 200km northeast of Vancouver, where the prevalence of COPD is twice the provincial average , 67% of the population lives on less than 40K, and the nearest health centre is up to 80km away on a twisting and dangerous highway: all risks to health.

Better health access in smaller places

Michel is part of the Community Paramedicine program created by B.C. Emergency Health Services (BCEHS) in 2015. The program is placing paramedics in 99 rural and remote places, which tend to be underserved by healthcare.

“CPs are problem solvers,” says Nancy Kotani, Chief of Transformation and Strategy at BCEHS. “Their role is proactive—building relationships and trust with patients, providers and the community as whole. It’s a completely new paradigm.”

Daily connections with patients

Supporting CPs in their quest to improve the overall health of their community is Home Health Monitoring (HHM) technology. HHM lets patients track their health at home while care teams monitor daily—and intervene if biometrics or self-evaluations move out of a healthy range.

“HHM is a natural fit for the CP program,” says Rita Jervis, TELUS Health’s Director of Transformation Services. “The two programs have the same goals: engage and educate those most vulnerable to health emergencies.”

CPs in B.C. are focused on patients with five risk conditions: COPD, diabetes, heart failure, risk of falls, and palliative. Clinicians in Fraser Canyon Hospital, the area’s nearest medical centre 45 minutes away in Hope, could not be more pleased.

Site Medical Director Dr. Josh Greggain: “Chris and the CP program are making an unbelievable difference for a handful of isolated and medically complex patients.”

Patients help themselves

Self-monitoring symptoms and vitals every day has a lot of upside. Patients can catch impending problems—say, a COPD flare-up—and act on their care plan, which might be as simple as taking prednisone.

“Fast treatment like that can help prevent deterioration, ambulance calls, hospitalizations,” says Dr. Greggain. “Our patients are getting better care with the proactive CP model than with reactive care from us.”

Changing behaviour and opening communication

Besides earlier interventions, another long-term plus is the learning and behaviour changes that result from HHM.

Michel: “Over time, patients get to know what good pulse oximetry is, what blood pressure levels to aim for, what weight to maintain. They understand their condition at a deeper level, and get to know what’s normal—and what’s not. And the comfort patients feel when they know someone’s looking out for them is absolutely huge.”

Michel and Greggain agree that relationships are unbelievably important to health. “Chris and his patients get along well and enjoy each other’s company,” says Greggain.

“Through relationships we build trust,” says Michel. “And when patients can trust you, they will open up about what’s really bothering them instead of being scared of what their symptoms could mean. And that’s when we can really help them.”

Easy tech for the non-techie

How are patients at home coping with using the new technology?

“Many of my patients are elderly and have never used technology before,” says Michel. “You can imagine how intimidating it is for them to sit down with the tablet, devices and TELUS Health system—they worry they might break it. But they quickly find that it’s very straightforward to use.”

“And our provider portal is equally easy to use.”

Serving the underserved

The use of HHM to help vulnerable and underserved patients will only grow as both the community paramedicine program and the core HHM program roll out across the province. Dr. Greggain wants to see this program expand into even more communities than the initial 99.

“By preventing daily emergencies, CPs stand to make a big difference in health in those hard-to-serve areas,” says Jeff Kingdon, TELUS Health’s Project Manager for the CP program.

See how Community Paramedics in Ucluelet and Kaslo, B.C. are helping patients stay healthy at home with Home Health Monitoring.

Learn how patient engagement solutions from TELUS Health can help improve health outcomes, increase patient and provider satisfaction, and lower care costs.
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