Over the past two decades, paramedics have been performing functions within local health systems beyond their traditional role of emergency transport. Examples include community paramedicine home visits and in-home palliative care. Many of these changes have happened in grassroots local systems without attention to high-level organizational and policy implications. In this exploratory project, we examine the changing roles of paramedics using the frameworks of integrated care.
The results of this study may help governments, healthcare leaders and the paramedic community understand key gaps in services and develop strategies to address them. This can inform the development of more integrated, patient-centred health and social services, and the appropriate organizational models and policy paradigms to support them.
Paramedics serve as flexible, adaptive capacity in health systems, filling an unmet need for health systems to be more responsive to local population needs. In collaboration with various care teams, paramedics perform unscheduled response functions and support prevention and primary care through clinical diagnostics and case-finding, targeting both broad, low-needs populations and more complex, high-needs populations. These findings support that integrated care systems can be enhanced by community-based services accessed through a single-point-of-entry, delivered by a generalist, flexible health workforce that is mobile in the community. This means reducing interprofessional barriers between health workers, fostering local organizational networks, allowing local control and experimentation, balancing standardization with flexibility and assessing value at a system level.