In 2012, Regional EMS Authority (based in Reno, NV) launched a system of community health programs to improve access to the appropriate level of healthcare throughout Washoe County, Nevada. Funded through a $9.1 million Health Care Innovation Award from the Center for Medicare & Medicaid Innovation, part of the U.S. Department of Health and Human Services, the program consisted of three interventions:
Nurse Health Line: a non-emergency phone number that provides 24/7 access to nurse navigators who could assess, triage and refer Northern Nevada residents to health care andcommunity services.
Alternative Destination Transports: paramedics conduct advanced assessments of 911 patients with low-acuity medical conditions and provide alternative pathways of care other than transport to a hospital-based emergency department, including transport to urgent care centers and clinics, a detoxification center, or mental health hospitals.
Community Paramedicine: specially trained community paramedics perform in-home delegated tasks and point-of-care lab tests to improve the transition from hospital to home and improve care plan adherence.
The comprehensive, integrated system created by these three interventions offered new referral and treatment pathways to ensure the safest and most appropriate care for patients with low acuity medical conditions. As a result, the innovative model successfully achieved the three goals of the Institute for Healthcare Improvement’s Triple Aim: improving the quality and experience of care, improving the health of populations and reducing the per capita cost of healthcare.