Community Paramedicine

This NFIRSGram explains the community paramedicine health care model and how to code paramedicine incidents in the National Fire Incident Reporting System (NFIRS).

What is community paramedicine?

Community paramedicine is an aspect of Mobile-Integrated Healthcare, wherein communities utilize specially-trained paramedics (often teamed with other healthcare practitioners and/or social workers) to address health problems, maximize the use of emergency care resources, and enhance access to primary care for medically underserved populations and those with acute and chronic health issues. Community paramedicine utilizes fire department personnel and paramedics to provide a variety of services to prevent emergency situations or reduce the likelihood of their occurrence in the future.

Interest in community paramedicine has grown substantially in recent years, based on the belief that it may improve access to and quality of care, while also reducing costs. Community paramedicine programs are usually designed to address local problems.

The typical services performed are:

• Coordinating health services for patients.
• Determining the need for, and providing referrals to, community resources (such as mental health, substance abuse, public health, and social services).
• Assessing safety risks for the patient (for example, disease, falls, and environmental health hazards).
• Assessing the safety of the work environment.
• Educating on proper use of health care resources.
• Providing oral health education and/or screening.
• Educating on identified health care goals.
• Performing a physical safety inspection (for example, home, property, and vehicle).
• Screening for chronic disease (such as diabetes, asthma, and coronary artery disease).
• Providing service with local public health agencies (for example, immunization and disease investigation).
• Providing service with local social service and aging agencies (for example, adult protection, child protection, senior services, and housing).
• Participating in wellness clinics (such as immunization and screening).

Coding community paramedicine

Due to the service that is being provided, and the expected increase in this type of service, fire departments should report these incidents in NFIRS using the recommended Incident Type code of 553 – Public Service. Do not group community paramedicine calls as nonreportable NFIRS calls, such as inspections or school visits. Incident Type codes in the 300 series suggest an actual emergency situation; whereas, the 500 series codes suggest a nonemergency service call (for example, assist invalid).

If the situation changes to an emergency while doing an assessment, the initial type of situation found changes to Incident Type 321 – Emergency Medical Services (EMS) Call, Incident Type 311 – Medical Assist, or Incident Type 554 – Lift Assist, whichever applies. In the meantime, departments are also encouraged to use a plus-one code to further identify these incident types.

If the situation warrants transportation to an urgent care facility or to another emergency department, then the fire department can escalate the incident type to 321 – EMS Call.

For Actions Taken (Section F of the NFIRS Basic Module), choose code 30 – Emergency Medical Services, other. Also ensure you include keywords (paramedicine, e.g.) in each incident Remarks field so you can quickly search for these calls at a later date.