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A Bridge to Primary Care for Rural Patients

By Susan Green

Years of working as emergency medical technicians (EMTs) in rural New England gave second-year Geisel students Nick Valentini '20 and Karissa LeClair '20 shared insight into the challenges patients face at home, and the need for a home healthcare resource that is readily available and of no cost to this vulnerable population.

The first partnership of its kind in New Hampshire, the pilot Community Paramedicine program, developed and implemented by Valentini and LeClair, provides ongoing care for patients with manageable chronic health issues by partnering medical students with Upper Valley Ambulance paramedics and EMTs to make house calls. The program launched earlier this year in two New Hampshire communities—Piermont and Orford.

"Providing preventative care is a great bridge between primary care and emergency medicine," LeClair says. "As medical students, we have no idea what patients experience in their homes and the same is true of physicians who send patients home with instructions without understanding that there may be obstacles to patients complying with those instructions. Nick and I saw these obstacles as EMTs, so we wanted to bring that awareness to medical students while also being a resource for patients."

Paramedics and medical students serve as the eyes and ears of a primary care physician when visiting patients in their homes—taking vital signs, reviewing medications (including over-the-counter drugs and herbal remedies), and listening to the needs of the patient to gain a better picture of their overall situation. Paramedic Stephen Sanborn says the program eases the logistical challenges of rural life.

"Nick and Karissa deserve a lot of credit for their persistence in making this happen," says Clay Odell, executive director of Upper Valley Ambulance. "With a territory encompassing nine rural communities spread over 340 square miles, there are many who could benefit from this service—I see this as a model for the future, particularly here in the Upper Valley."

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