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others, the partnership with paramedics providing urgent, telemedicine-enhanced assessments and coordinated care with the MACT physician is critical to the success of the program to avoid unnecessary hospital - izations and emergency room visits during the MACT episode. "We are excited about the paramedicine aspect of the program and have begun training both our paramedics as well as our physicians, who are specialists in internal medicine and/or geriatrics, for this new care model," Munjal says. "The program is envisioned to work as follows: A nurse and physician will be available 24/7 to address any concerns the patient has over the phone. Experience with the hospital- at-home model elsewhere has shown that some proportion of these calls will not be resolved over the phone, and cannot safely wait for when a nurse practitioner, physi- cian or nurse is available for an in-home visit. The on-call physician will activate the paramedic response when he or she decides the patient requires urgent atten- tion. Paramedics will visit the patient at home and operate under NYC regional ALS protocols but without automatically transporting to the hospital. "With the help of eBridge, a video confer- encing and telemedicine technology [from General Devices], paramedics will par- ticipate in real-time consultation with the MACT physician in order to make a collec- tive and informed decision as to the appro- priate course of action," Munjal continues. "In this model, the paramedic will take med- ical direction from the MACT physician to administer medications and treatments in the paramedic's existing scope of prac- tice to help with patient symptoms and disease. The physician and patient will engage in shared decision mak ing regarding t ra n spor t at ion to the hospital. Patients will retain their rights to be transported to the hospital if they so desire or will document their prefer- ence to stay home in writing." Munjal says patients, caregivers and the general community have been very sup- portive of the overall MACT initiative. Patients seen in the emergency depart- ment are evaluated for inpatient admission through the usual pathways, and a patient will be considered for the MACT program only after the decision to admit has been made. He explains cases will be reviewed to identify patients who can be cared for safely at home. The following diagnoses will be considered: Community-acquired pneu- monia; urinary tract infection; congestive heart failure; diabetes; chronic obstructive lung disease; cellulitis; venous thromboem- bolism; and asthma. EMSWORLD.com | MARCH 2015 37 In partnership with: Brought to you by: APRIL 28, 2015 WASHINGTON, DC Immediately preceding the EMS on the Hill Day briefi ng. THRIVE IN THE EVOLVING WORLD OF INTEGRATED HEALTHCARE The rapid evolution into community paramedicine and mobile integrated healthcare has been one of the most discussed issues in the EMS arena. Attend this exclusive event and hear from your peers as they share real-life examples of successful programs in action. Agenda includes individual and panel discussions covering: • W hy We Need Reimbursement Reform • How to Develop an MIH-CP Program • Economic Sustainability for MIH-CP Programs • The Role of Data Metrics and Outcome Measures • MIH-CP Programs in Action • How to Build Winning Relationships and To register, visit MIHSummit.com/register. Register before April 10 and save! Next Month: Home Health/ Hospice Collaborations