In Marion County and across the nation, there are factors that drain the resources of EMS services and their capabilities to provide the appropriate care, when needed.  One issue being addressed is recidivism to an emergency medical facility, even though treatment is accessible.  Through community outreach programs, such as CORE, IEMS is addressing the issue of repeat hospitalization by meeting the needs of vulnerable and high-risk populations and working in partnership with others to address specific issues contributing to the strain on our emergency medical system.

A growing need was identified and a partnership was formed between IEMS and Riley Hospital for Children to address how to conduct in-home interventions for high-risk pediatric asthma patients. According to the Indiana State Department of Health, asthma is the most common chronic childhood illness, affecting one in 10 children under the age of 18. Thanks to a nearly $1 million grant from the Health Resources and Services Administration (HRSA) in 2013, “Treat the Streets” was launched to improve how childhood asthma is medically managed, in an effort to reduce hospital readmission.

Potential “Treat the Streets” participants are identified simply by admission to inpatient, observation, or the emergency department for primary diagnosis of asthma, and have met other standard criteria of being between the ages of two to 17, and live in Marion County. Once parental consent is given, an appointment is made to have an IEMS paramedic, along with a CORE social worker visit the patient at their home to conduct a medical and environmental assessment, plus asthma education to the patient and their family.  Other resources may also be available on a need-by-need basis, including furnace filters, vacuums, pillow cases and free smoking cessation provided by the Marion County Public Health Department, who may also be contacted for environmental or housing issues.  This approach is to address gaps in care that exist after the child is discharged from the hospital.

Overall, the goals of Treat the Streets are to:

  1. Prevent emergency department and hospital readmission
  2. Improve health care access with an integrated health care model to ensure that the right care is available to patients at the right time and in the right environment
  3. Develop a workforce of specially trained out-of-hospital care providers to implement various prevention and intervention strategies
  4. Conduct research, analyze data and disseminate results regarding the impact of the pediatric community paramedicine model of emergency department recidivism rates and enhanced paramedic scope of practice
  5. Recommend strategies for bundled health care services, provided by Indianapolis EMS, ensuring sustainability of the program
  6. Final data analysis is expected sometime in 2017, but Treat the Streets has already shown the power of strong partnerships and the effectiveness of CORE’s service delivery model to reach into the community to focus on specific needs of a wide variety of residents.