Community paramedic program expands to east metro

Thea Kogler spent nearly two decades as an EMT and paramedic rushing to emergencies.

"When I would go on a 911 call, I would find myself thinking, if I just had half an hour to talk to that person, I could really help that person not go to the emergency room," she said.

Kogler is now part of M Health Fairview's Community Paramedic Program, where she meets with patients at their homes and helps them organize medications, attend virtual doctors' appointments and care for healing wounds with the goal of preventing medical crises and improving their overall health.

The program, one of a handful in the state, was launched in the west metro in 2018 and expanded to St. Paul and the east metro this summer. There are now four community paramedics, including Kogler, plus a community health worker, making house calls. The team sees about 50 patients a week.

Patients who qualify for the program are offered care free of charge. The program is funded by Fairview and grants from UCare and Blue Cross and Blue Shield of Minnesota.

Community paramedics were first authorized to practice in Minnesota in 2011 to reduce emergency room visits and hospitalizations, according to a state Department of Heath report. As of February 2019, the state had 139 certified community paramedics, which the report described as "an emerging profession in Minnesota and in the nation."

Kogler, who previously worked in Alaska, had some community paramedic experience before joining the M Health Fairview team. She sees three to four patients a day and can spend from 45 minutes to two hours on a call.

Kogler said people are less anxious at home and more candid about health issues and struggles.

"You can just see them relax. There is no hurry and no rush," Kogler said. "We give them time to ask all the questions they want."

Kogler's work involves basic health care such as taking vital signs, drawing blood and caring for wounds. But she also brings her laptop to help patients attend virtual appointments and makes sure they understand and can carry out doctors' orders.

She sees firsthand which medications someone is taking and how they are organized; if they're prone to forget, Kogler will suggest putting the pill box next to the toothbrush or coffeepot so it becomes part of the daily routine.

Kogler said she is able to address safety issues. She might change smoke detector batteries or suggest moving throw rugs and other tripping hazards. The Community Paramedic Program also recently started delivering food boxes to patients who are food insecure.

Early data show a drop in emergency room visits and inpatient hospital visits among people enrolled in the program.

Jenny Kolb, who helps oversee the program as M Health Fairview's system manager of care management, said they track numerous pieces of patient data. One that is particularly meaningful for her: Patients enrolled in the program report more healthy days.

"To us, that speaks so loudly that we are improving the quality of life for our patients," Kolb said.

Robert Demulling, who is diabetic, had a heart attack earlier this year. He's back home in Wyoming, Minn., but staying up to date on his medications can be a challenge.

"I take 14 pills a day," said Demulling, a retired St. Paul school bus driver who lives alone. "I just get so confused."

"She sets my pills up and writes down what I need to order from the pharmacy," Demulling said. "Without her, I don't what I would be doing right now."

Demulling said when he started feeling ill, Kogler worked with him and his doctor and finally determined he was taking too much of one medication.

With the extra help at home, he said, "I've never felt better."