Pittsburgh was the birthplace of paramedicine with the Freedom House ambulance service half a century ago. Today, the city is aiming to remain at the forefront of the field by expanding a follow-up care program within its Emergency Medical Services department.
On Tuesday the city announced that its Office of Community Health and Safety and Pittsburgh EMS will lead a city-wide “community paramedicine” program, which will connect patients to preventative health care resources and make referrals to providers.
“It's the first time in the city's history … that we have embarked on a committed community paramedic program,” said Laura Drogowski, manager of the city’s Office of Community Health and Safety. She will direct the program alongside EMS Community Paramedic Chief John Mooney.
Drogowski noted community paramedics have a rich history in Pittsburgh through the Center for Emergency Medicine of Western Pennsylvania. The city program marks the first time Pittsburgh's own EMS department will have such a division.
The four-person unit will work with EMS services to determine when a patient could benefit from a follow-up call to address chronic issues. Officials report that patients who frequently call 911 are often suffering from chronic conditions that are difficult to manage, such as seizure disorders, obstructive lung diseases, diabetes and heart disease.
According to the city, patients who use EMS services often also tend to call for minor falls, mobility challenges and mental health issues — problems that first responders aren’t always equipped to deal with.
“The way that our first responders interact with patients is that they come during a 911 call,” Drogowski said. “And by the nature of their work, they are not afforded time to spend hours or days with that patient to rectify the situation.”
But Mooney said paramedics want to help, especially because if those needs go unaddressed, patients’ health outcomes can worsen.
“It's devastating for first responders to regularly witness patients decline in health over multiple visits,” Mooney said.
Prior to this week's official launch, Mooney and three EMS personnel have been working overtime shifts since late 2021, testing a pilot program to provide follow-up care to patients after 911 calls. The team found that many patients who frequently call EMS are living with health conditions like seizure disorders, obstructive lung diseases, heart disease and diabetes.
According to Drogowski, the small team has worked with patients struggling with breathing devices or with managing blood sugar. But she noted that community paramedics could also follow up with patients who simply need to be connected to a primary care provider, or to find equipment to manage their symptoms.
She said while these seem like “situations that may seem not too difficult to solve,” paramedics often don’t have the capacity to make sure someone followed up with a primary care provider or bought a refrigerator to keep their medicine.
The unit will also collaborate with other co-response units in the city, Drogowski said.
The community paramedics will coordinate with social workers in the police bureau to determine how best to follow up with patients. Drogowski argued that some health issues stem from situations like a financial crisis.
“If someone's utilities are being shut off, they may not be prioritizing going to their primary care physician," she said. “Sometimes it's helping to address the issues that are precluding them from taking care of themselves.”
Other joint programs involving public safety workers include collaborations with the bureaus of fire and police. Drogowski said she hopes to expand these efforts to ensure the city can mend holes in the social safety net.
“Falling through the cracks means that people die, alone, from treatable conditions. Our first responders see them every day,” Drogowski said. “We are committed to changing these outcomes, providing advocacy, connecting patients with resources, and fighting for what is needed."
