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Community Paramedicine on the Big Island

Sherry Bracken

Ambulance services on every island have a number of clients who are frequent callers—some more than 50 times a year.  On Hawai'i Island, the 300 most frequent 9-1-1 callers make up eleven percent of their total calls, at a cost to the health care system of around $7 million dollars. Hawai'i County’s Fire Department is now using a new system to improve the situation. From Hawai'i Island, Sherry Bracken has more.

Hawai'i County’s Fire Department handles 9-1-1 ambulance calls. Statistics show a small number of people use the service the most—often not for true emergencies. Hawai'i County Fire has two Paramedic/EMTs who now focus on providing better patient care plus more efficiency in what’s called Community Paramedicine. Jesse Ebersole represents East Hawai'i.

“Community paramedicine started in Europe, UK, Australia, Canada, and in the United States there’s been programs popping up over the last 10, 15 years. A new way of doing business, proactive, rather than the traditional call 9-1-1, get an ambulance. We’re targeting our high utilizers, our frequent flyers. We’re also trying to target our under-utilizers, who are vulnerable, disconnected from health care. We’re also targeting our homeless population.” 

Ebersole says they make unscheduled visits to frequent callers, and because they’re Fire Department EMTs, they’re usually welcomed. 

Vern Hara is responsible for Community Paramedicine in West Hawai'i.

“Our whole goal with the community paramedicine project was to keep our medics available for true emergencies and yet service the community without adding to the budget. We take care of our elderly. We do home visits, safety assessments. We work with a lot of agencies, to connect them with services to keep them from calling 9-1-1 and from getting into emergency situations.”

Hara says he visits the West Hawai'i homeless shelter and homeless encampments, along with partners from West Hawai'i Community Health Center.

“We do weekly wound care sessions, hopefully keep them out of our ambulances, out of our hospitals. If it’s something we can’t treat on site, we make appointments with the doctors at West Hawai'i Community Health Center.”

Both Ebersole and Hara say Community Paramedicine helps patients and the county. They estimate they’ve been able to save the health care system more than $1 million dollars in the last year.

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