Redmond paramedic's focus: preventative care

Fire department has area's first community EMT

A new kind of paramedic

REDMOND, Ore. - The rush to save a life is second nature for a retired paramedic who spent decades in a hurry.

But these days, Dan Cox takes his time packing his medicine bags.

"A paramedic firefighter is all about emergency response," Cox said Tuesday. "But later in my career I'd learned that slowing things down and visiting with patients in their home was really good medicine."

Now Cox has he self-described dream job: he's Central Oregon's first community paramedic, a new grant-funded program recently launched by Redmond Fire and Rescue in partnership with health care providers including St. Charles, Mosaic Medical and Pacific Source Community Solutions.

The idea is something of a reverse approach for first responders -- get the patient healthy on the front end and avoid the emergency.

"We will take health care into the patient's home, completely outside of the 911 system," said Redmond Fire Division Chief Doug Kelly.

Kelly said it's a new approach emerging nationwide. He wanted to bring it to Central Oregon.

"The health care system in the U.S. has been broken for some time," Kelly said. We really saw that there's an access problem to health care throughout our tri-county area."

Kelly said the initial focus will target a specific population. People who qualify for the program will be Medicaid patients diagnosed with chronic obstructive pulmonary disease, congestive heart failure and diabetes.

"We're working to reduce re-admissions (to the hospital)," Kelly said. "For instance, (when) a congestive heart failure patient is discharged from the hospital, they have a 25 percent chance of coming back to the hospital within 30 days."

Cox will perform in-home care visits in Deschutes, Jefferson and Crook counties.

"We saw a niche here of the health care gap, for those who don't have a car to make it to the physician's appointment or are otherwise constrained," Kelly said.

To qualify, doctors must refer Medicaid patients to program. Once accepted, Cox will work with the doctors to develop a treatment plan and then will coordinate regular visits with the patients.

Currently, Cox treats three patients who all live in the Bend area and have specific needs.

"I've done home safety inspections, vital signs, blood pressure, oxygen levels, EKGs," Cox said.

However, he said the most important part of his job might have nothing to do with pills and blood pressure.

"I want to build their self-esteem, and educate and (help them) take responsibility for health, and that's been really rewarding," Cox said.

Kelly hopes the program will expand to treat 50 to 80 patients within the next few months. The one-year, $192,000 grant for the program comes from the Transformation Funds  of the Central Oregon Health Council.

Officials also hope to eventually expand the focus of the program to include anyone who makes frequent -- and costly -- trips to the emergency room.

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