Mayo Clinic's McCoy gets hero award for work in community paramedicine
Nov. 23—ROCHESTER — There was little in Mayo Clinic Dr. Rozalina McCoy's early medical career to suggest the work she performs today: Developing ways to deliver health care to hard-to-access places and people through the use of community paramedics.
Paramedics are typically thought of as health professionals who jump into ambulances and rush to medical emergencies. Community paramedics are mobile, too, but their role is preventative and more comprehensive. They go to the hotels, homes and homeless shelters, and find patients before the situation can develop into a full-blown medical crisis.
Recently, McCoy, medical director of Community Paramedic Program, Mayo Clinic Ambulance, Rochester, received the 2022 Minnesota Rural Health Hero Award for her work establishing a community paramedicine program.
"For me, personally, this has been probably the most rewarding thing I have ever done," she said.
The route to her current work began as a researcher. McCoy's focus is on diabetes management.
Community paramedicine was a response to a particular health care challenge: One of the biggest reasons that diabetics suffer from poor health is their inadequate access to care. A recurring phenomenon among many diabetics is episodes of low blood sugar, a dangerous but "completely preventable" situation, McCoy said.
Oftentimes, paramedics are dispatched to a patient with a low-blood sugar condition to stabilize them with sugar. But delivering medical care that way is costly, and it was happening repeatedly. Talking with paramedics, McCoy learned that low-blood sugar is the most common reason for an ambulance to be called.
There had to be a better way — a less costly way. With the help of two grants, McCoy and her team developed an approach "where community paramedics would go out and care for people with low blood sugars."
And the idea has grown from there.
PB: How do community paramedics differ from traditional ones?
McCoy: You can think of them as kind of specialty trained paramedics. All of them are paramedics in the traditional sense of the word. They work on our ambulance service, they respond to emergencies, they deliver life-saving acute care. Community paramedics get additional education and training in non-emergency medicine.
So how do they do their job?
We have several different pathways for patients to get in. Most of their appointments are prescheduled appointments. Patients are referred to see them in their home or shelter or the streets — really anywhere they are. The community paramedics go to their location, do patient assessments, develop a plan of care, and deliver the intervention. So what makes it similar to paramedics is that they all practice outside of the hospital or outside of the traditional health care walls.
Community paramedicine builds on the notion of getting health care to the people, rather than making the patient come to the clinic. How do you find these patients?
Our partnership with The Landing (a day shelter that offers access to medical care and social workers) has been instrumental to find the most underserved patients. And the way we did that is, before we opened our clinic there, we spent time at The Landing getting to know people and earning their trust. Once we did that, we opened up the clinic, which is an entirely drop-in clinic. No appointments are necessary. And a lot spreads by word of mouth.
Where did the concept of community paramedicine come from?
It's been growing over the past 20 or so years. Community paramedicine came out and is very robust in Canada and Australia. It was initially focused on preventing hospital readmissions, so they work in rural areas or urban areas. Minnesota is actually a national leader in community medicine. In 2012, it became a recognized profession in the state, and Medicare has been reimbursing community paramedic services since that time
How big could community paramedicine grow?
Twenty-five years from now, I think ambulance services might be in large part community paramedic services. They will not only provide emergency care and transport patients, but they'll also bring primary and comprehensive care to their homes. I think it's the future for ambulance organizations.
It will depend on having value-based care models rather than fee-for-service models where we're paid for high-quality care. I think that is instrumental to the growth of CP models, because I think the biggest barrier is the fact that it's largely not reimbursed other than in Minnesota.
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