<body><div><figure><img src="https://img.particlenews.com/image.php?type=thumbnail_580x000&amp;url=1a33zw_1DxMtFlI00" alt="https://img.particlenews.com/image.php?url=1a33zw_1DxMtFlI00" width="640" height="480" ><figcaption>Provided Photo</figcaption></figure><h2>Introduction </h2><p>Emergency medical services (EMS) across the country are facing a growing crisis as rising 911 call volumes, largely driven by low-acuity complaints, have strained EMS systems and emergency departments (EDs). This demand puts considerable pressure on local resources, leading to provider burnout, understaffing, fiscal burden, and limited capacity to serve communities. </p><p>The rise in low-acuity calls stems from multiple patient-level factors, including patients’ inability to access primary care, lack of transportation, financial concerns, low healthcare literacy, and confusion about appropriate care options. With few alternatives, many patients turn to EMS, leading to ED overcrowding and increased wall time and unit-hour utilization in our pre-hospital systems. </p><p>Ultimately, a traditional EMS handling of these cases often results in unnecessary patient transport, even though many low-acuity complaints can be managed with comprehensive on-site medical guidance and treatment at the scene. </p><p>To address the burden of low-acuity 911 calls, Greenville County EMS (GCEMS) in upstate South Carolina launched the Prehospital Assisted Treatment and Healthcare Services (PATHS) program. The PATHS program uses a treatment-in-place model to manage specific non-acute complaints at the scene rather than transporting patients by ambulance to the ED.</p><p>Patients enrolled in the program receive a follow-up from the PATHS team, led by a nurse practitioner and two community paramedics who can treat acute complaints by phone or within the home and/or provide healthcare navigation to the appropriate venue (e.g., urgent care, primary care). Through a comprehensive treat-in-place response plan, the PATHS team aims to provide high-quality, targeted patient care for low-acuity calls, thus reducing costly EMS transport, minimizing ED visits for non-emergent issues, relieving system overload, and increasing patient satisfaction. </p><h2>The PATHS Program Model </h2><p>Since the PATHS program’s inception, its operations have anchored on the premise that frequent non-acute 911 calls stem from widespread deficits in healthcare education and access across the county, including the financial and transportation barriers a patient may face that limit their participation in preventive and primary care. The PATHS team identifies and addresses these social drivers of health (SDOH) to promote sustainable access to appropriate care, reducing reliance on the 911 system for low-acuity complaints. </p><p>The PATHS team consists of a nurse practitioner (NP) and two community paramedics (CPs) who provide triage, clinical assessment, and treatment; conduct on-site evaluations; support interventions; coordinate care; and ensure patients are connected to appropriate resources through ongoing follow-up. After initial entry into the program and intervention, a patient maintains direct communication with the PATHS team for further resources or future care. </p><h2>How Patients Enter the PATHS Program </h2><p>The main entry points to the PATHS program are through the Greenville County Emergency Medical Services (GCEMS) 911 dispatch system and EMS crew referrals. </p><h2>Entry Through the 911 System</h2><p>The primary entry point is the 911 system, where non-acute calls are screened by dispatch and transferred to the PATHS team. Communications professionals automatically flag certain call complaints as “PATHS-eligible” based on acuity and category, using prior program success statistics to guide eligibility criteria. </p><p>The PATHS-eligible complaint codes used by the GCEMS Communications Team (“MedCom”) during initial triage are listed in Figure 1, along with general eligibility criteria and exceptions that would deem a complaint ineligible. </p><figure><img src="https://img.particlenews.com/image.php?type=thumbnail_580x000&amp;url=15sppj_1DxMtFlI00" alt="https://img.particlenews.com/image.php?url=15sppj_1DxMtFlI00" width="936" height="657" ><figcaption>Figure&nbsp;1. PATHS-Eligible Protocol Codes and Patient Eligibility Requirements *For each protocol code, the first number refers to the Medical Priority Dispatch System (MPDS) category. The&nbsp;subsequent&nbsp;letter refers to the acuity level, with A (Alpha response) referring to a low-acuity situation and O (Omega response) referring to a non-emergency or public assist complaint. The final number denotes the call’s EMD code, which defines the exact medical issue under the protocol category.</figcaption></figure><p>When a call is transferred to the PATHS team after MedCom triage, a CP or the NP obtains the patient’s consent to begin the PATHS intervention and initiates further triage over the phone. While the PATHS eligibility criteria allow rapid identification of calls that can be handled with a PATHS intervention, this initial triage step by the PATHS team serves as an additional safety net to ensure that the appropriate level of care is established and that EMS transport is not required. </p><p>After triage, the PATHS team is delegated to respond to the case. The entire process, from the initial call to the PATHS response, is visualized in Figure 2 below, including call dispositions for either PATHS intervention or an elevated response via EMS transport. </p><figure><img src="https://img.particlenews.com/image.php?type=thumbnail_580x000&amp;url=37CLpH_1DxMtFlI00" alt="https://img.particlenews.com/image.php?url=37CLpH_1DxMtFlI00" width="936" height="711" ><figcaption>Figure 2. Example GCEMS PATHS-Response Flow * NP=nurse practitioner / nurse practitioner callback, CP=community paramedic, CADV=care&nbsp;advice, UCF=urgent care&nbsp;facility, REP=referral to external provider, NPHV=NP home visit scheduled, CPHV=CP home visit scheduled, CPOS=EMS requested, CPTR=transport required,&nbsp;CaPro=care&nbsp;provided&nbsp;</figcaption></figure><h2>EMS Crew Referrals </h2><p>Another way for a patient to access the PATHS program is through GCEMS crew referrals. In this approach, 911-based EMS clinicians identify repeat callers to 911 with low acuity and refer them to PATHS. </p><p>Enabling patient referrals from the 911 EMS clinicians enables the PATHS program to offer additional care to patients who may be eligible but might otherwise be missed by automated or systematic low-acuity call sorting. Additionally, allowing EMS crew referrals fosters collaboration and strengthens EMS clinician engagement with the PATHS program. </p><h2>Program Reach, Utilization, and Satisfaction </h2><h2>Program Reach </h2><p>Since the program started on October 13th, 2025, there have been 6,582 patient events with an emergency medical dispatch (EMD) code eligible for the PATHS program. Of these, 3,805 (57.8%) occurred outside staff hours and were therefore unable to receive a PATHS intervention. </p><p>Additionally, 436 (6.6%) were not eligible due to facility reasons, 151 (2.3%) involved the patient requesting an ambulance, 622 (9.5%) did not fall within the eligibility criteria (Figure 1), and 59 (0.9%) occurred when CP staff were unavailable due to meetings or non-clinical responsibilities. After accounting for these barriers to PATHS intervention, 1,509 (22.9%) calls were eligible for a PATHS response. </p><p>Ultimately, the PATHS team was assigned to 431 (28.6%) of these eligible incidents. Of these 431 encounters, 269 had a PATHS visit, 147 were transported, and 15 were canceled. </p><p>Common reasons for transporting the patient following a PATHS interaction included patients wanting transport to the hospital for faster access to the ED or due to preferring hospital evaluation, inability to participate in the program for cognitive reasons (e.g., altered mental status, dementia, confusion, etc.) or inebriation (e.g., alcohol or substance misuse), or showing signs and symptoms incompatible with the PATHS program (e.g., high blood sugar, hypertension, difficulty breathing). </p><h2>Population and Services Provided </h2><p>Most PATHS participants (N=269) were female (61.7%) and White (60.1%), with a median age of 59 years (IQR=43.0–77.0 years). </p><p>The most common dispatch reasons for PATHS visits were: Sick Person (67.8%), Abdominal pain (14.3%), Back pain (5.4%), Traumatic injuries (4.2%), Falls (3.1%), Allergies (1.5%), and Diabetic problems (1.5%). Other complaints included headaches, hemorrhage/laceration, burns, eye problems, heat/cold exposure, overdose, and choking. </p><p>Over half of PATHS patients (52.8%) received a procedure from the PATHS team, with many receiving multiple procedures. Procedures included EKG or cardiac monitoring (19.7%), blood labs, urinalysis, or vital tests (10.8%), urinary catheter adjustment or removal (6.8%), wound care or bandaging (6.0%), consultation with the NP (4.1%), and/or IV fluid or medication administration (3.0%). </p><p>Many patients also received medication from the PATHS team, including Toradol, ondansetron, normal saline, acetaminophen, and oxygen. Less frequently provided medications included ibuprofen, triple antibiotic, albuterol, aspirin, Benadryl, Hibiclens, and lidocaine. </p><h2>Patient Satisfaction </h2><p>Of the 394 patients seen by the PATHS team, 30 (7.3%) completed a patient satisfaction survey for a CP in-person call (n=29), an NP in-person call (n=20), or an NP telemedicine call (n=5). Patients report high satisfaction with the care provided by the CP and the NP, with &gt;90% agreeing or strongly agreeing that the clinician listened to their concerns, asked how their illness affected their everyday lives, and showed genuine interest in their concerns. </p><p>Additionally, &gt;90% of patients agreed or strongly agreed that they felt confident discussing their problems with the CP/NP and that they did not feel rushed during the conversation. Overall, 94.4% reported high satisfaction with the care received by the PATHS program. </p><figure><img src="https://img.particlenews.com/image.php?type=thumbnail_580x000&amp;url=1muP8N_1DxMtFlI00" alt="https://img.particlenews.com/image.php?url=1muP8N_1DxMtFlI00" width="240" height="320" ></figure><h2>Early Successes and Limitations </h2><h2>Early Successes </h2><p>The first seven months of PATHS implementation have shown several early signs of success. First, the program showed promise in diverting a meaningful subset (28.6%) of eligible calls from traditional EMS transport, and two of every three patients seen by the PATHS team were provided care within their home without transport to the hospital. </p><p>This demonstrates the high feasibility of a treat-in-place model for eligible low-acuity complaints. Additionally, the program’s strong focus on high-quality treat-in-place care successfully embodied its mission to use patient-centered principles and SDOH to increase patient satisfaction, as &gt;90% of patients responding to the patient satisfaction survey reported high levels of satisfaction across multiple measures of communication, attentiveness, and trust. </p><h2>Initial Limitations </h2><p>The PATHS program has also identified and addressed several challenges that have limited reach and program implementation. The key barrier to handling patient volume is limited operational capacity. </p><p>A large proportion (57.8%) of otherwise eligible calls occurred outside PATHS staffing hours, preventing intervention in more than half of eligible cases. The PATHS program also experienced difficulties integrating with traditional EMS MedCom workflows, which at times led to low program volumes. </p><p>One way the program has addressed this issue is through self-dispatch, where PATHS CPs monitor incoming complaints in real time to identify cases and call characteristics suitable for intervention, even if not initially dispatched to the program. The PATHS program director is also improving EMS integration by providing ongoing education to 911 EMS staff, strengthening communication and collaboration with the PATHS team. </p><p>One large barrier to decreasing 911 calls for acute care identified by the PATHS team is the logistical challenges that patients face that restrict access to fundamental follow-up services and resources. For example, many patients face delays in Medicaid enrollment, lack prompt home health response, and experience barriers to acquiring durable medical equipment or affordable medications, all of which lead patients to turn to EMS and the ED as fallback options to obtain necessary care. </p><p>Developing partnerships with community organizations will help address many of these patient inequities, increase awareness of PATHS, and strengthen trust across the community. </p><p>Finally, as the PATHS program matures, addressing its sustainability will become increasingly important. With funding from insurance reimbursement, the PATHS program could operate with increased self-sufficiency in our communities. </p><p>Although numerous states have enacted legislation enabling Medicare and Medicaid reimbursement for EMS treat-in-place programs, South Carolina has not yet adopted such measures. Future growth will need to be met with expansions in how the program funds its operating expenses, enabling it to continue to provide no-cost treat-in-place care to all, regardless of ability to pay. </p><figure><img src="https://img.particlenews.com/image.php?type=thumbnail_580x000&amp;url=2j3lqA_1DxMtFlI00" alt="https://img.particlenews.com/image.php?url=2j3lqA_1DxMtFlI00" width="640" height="480" ></figure><h2>Conclusion </h2><p>The PATHS program demonstrates how EMS systems can evolve to meet growing demand while continuing to maintain a high standard of patient care. With proper implementation and funding, programs like PATHS are not a short-term fix, but a forward-looking model for EMS care. </p><p>Early results show that many low-acuity patients can be treated in place and are highly satisfied with the care they receive. In response to rising call volumes and system pressures, programs like PATHS provide EMS agencies with a modern approach to administering timely, treat-in-place care in their communities. </p><p>For agencies looking to reduce unnecessary transport, improve patient experience, and better integrate with the larger healthcare system, the PATHS model offers a definite way forward. </p><h2>Funding </h2><p>The Prehospital Assisted Treatment and Healthcare Services (PATHS) program is made possible through a grant from the BlueCross® BlueShield® of South Carolina Foundation, an independent licensee of the Blue Cross Blue Shield Association.</p></div></body>

Block Source: jems.com

Misinformation

Clickbait

Old or repetitive news

Explicit content

Location not relevant

Emergency medical services (EMS) across the country are facing a growing crisis as rising 911 call volumes, largely driven by low-acuity complaints, have strained EMS systems and emergency departments (EDs). This demand puts considerable pressure on local resources, leading to provider burnout, understaffing, fiscal burden, and limited capacity to serve communities.

The PATHS Model for Handling Low-Acuity 911 Utilization

NewsBreak

Emergency medical services (EMS) across the country are facing a growing crisis as rising 911 call volumes, largely driven by low-acuity complaints, have s

The PATHS Model for Handling Low-Acuity 911 Utilization

Comments