Josh Pobrislo, left, and David Champagne, the team’s lead paramedic, stand by the clinically outfitted RV used to provide health services for patients of the Cardiac Fellows. Contributed / Josh Pobrislo
A new program at MaineHealth is bringing specialized cardiac care to unhoused and low-income residents throughout Greater Portland.
A MaineHealth NorthStar community paramedic team launched the program in late December in partnership with the Cardiac Fellows, a three-year program through MaineHealth where medical providers train to become cardiologists. It’s already drawing interest from other departments.
In addition to other duties, the nine providers in the Cardiac Fellows program each oversee patients, many of whom either can’t travel or get access to outpatient care.
“There’s not enough care management available in the Greater Portland area right now,” said Darcy Chandler, the Cardiac Fellows program coordinator. “Some companies are no longer accepting patients due to short staffing, so a lot of our patients are going home without services.”
Josh Pobrislo, operations manager for MaineHealth NorthStar’s inter-facility transport division, heads up the community paramedic team for the program. When patients can’t connect with services, the team brings those services directly to them.
“We go out and we do blood draws, we do weight checks, we do med checks,” Pobrislo told The Forecaster. “We have a translator system that is part of MaineHealth that we use because a lot of our population thus far speaks a foreign language.”
Using a clinically outfitted RV, the team provides most of its services in Portland, South Portland and Westbrook, but has treated patients in Windham as well.
“We actually met a patient in a parking lot once because he was living out of his vehicle,” Pobrislo said. “We were able to do everything we needed inside of that RV.”
The paramedic team also allows Cardiac Fellows to adjust patients’ medications on the fly.
“They do their checks and then I can reach out to the doctors at the moment and we can make medication changes while they are there,” Chandler said. “We’re able to get their bloodwork drawn and help them get on the right medications to protect their hearts moving forward.”
Pobrislo said they’re able to be “the eyes and ears of the physicians,” which Chandler said is very helpful.
“It helps with their continuity of care,” she said. “We’re even reaching patients that are having a hard time following up. We’re able to assess those barriers for them coming to appointments so they can get the follow-up they need.”
The program is already having a noticeable impact.
“As a result, they’re having decreased hospitalizations and decreased office visits,” Chandler said.
The MaineHealth program is similar to an effort Pobrislo led when he worked as a paramedic and local health officer in South Portland. Project Outreach, launched during the pandemic, provided resources at hotels in the city that were temporary shelters for unhoused people and asylum-seeking families. That effort began to connect people to services and provide education surrounding COVID-19, but evolved to connecting them with other forms of healthcare as well, such as mental health and substance use treatment.
The program at MaineHealth goes beyond connecting people to resources, Pobrislo said. It brings the resources to them.
“It’s been super, super neat to get into what I was doing in South Portland but on a much deeper clinical level,” Pobrislo said.
Other departments within MaineHealth have expressed interest in having Pobrislo and his team work with some of their patients as well. Pobrislo said that would require the community paramedics, currently part of the NorthStar division of MaineHealth, to become its own department – and that’s the goal.
“I think there are opportunities with post-surgery to prevent infection and readmission,” Pobrislo said. “I see diabetes being another big one we can help with, congestive heart failure, diuretic therapies.”
“I would love to see it go out to primary care offices and all of the specialties,” Chandler said.
Barriers to expanding the team’s services include the need to hire more community paramedics and a billing system.
“Right now this is just 100% free because we have no means to bill or collect insurance or Medicare or anything like that,” Pobrislo said. “Our hope is to continue to explore those kinds of avenues so we can expand to work with other divisions.”
Copy the Story LinkComments are not available on this story.
Send questions/comments to the editors.
