Community Paramedicine Program

Location: County of Renfrew, Ontario

Partners:

County of Renfrew, Ontario Ministry of Health, local hospitals, paramedic services, and private telehealth providers

Summary:

A PPP-enabled service where paramedics perform non-emergency home visits, leveraging telehealth technologies in partnership with private providers.

Impact:

Reduced ER visits, improved elderly care access, and optimized resource use in vast rural territories.

Project:

Mobile healthcare delivery to vulnerable rural populations.

Overview:

A proactive healthcare program using paramedics to deliver in-home care, enabled through partnerships with telehealth providers and academic institutions.

Participants & Stakeholders:

Public Sector: Renfrew County, Ontario Ministry of Health

Private Sector: Telehealth providers (e.g., Medtronic for remote monitoring)

Healthcare: Renfrew County Paramedic Services, local hospitals

Academia: University of Ottawa (program evaluation)

Leadership: Chief Michael Nolan, Renfrew County Paramedic Services

Consulting Vendors: Health systems evaluators, medical tech specialists

Value Role Mapping:

County & Health Ministry: Funding, policy enablement

Paramedics: Service delivery

Private tech vendors: Remote diagnostics tools

University: Impact research

Value Contributions:

Ministry: Policy and funding

Paramedics: In-home service delivery

Tech Vendors: Remote patient monitoring

University: Research and outcomes analysis

Goal:

Reduce hospital dependency and improve access to care

Roadmap & Results:

Discovery & Design-

Success Factor: Mapped top 10% of repeat ER users and homebound residents

Planning & Configuration-

Success Factor: Integrated Medtronic remote monitoring into EMS protocols

Pilot & Test-

Result: 25% reduction in emergency room visits during first pilot phaseExecution & Scaling

Result: Expanded to 15+ rural communities in the county

Governance & Innovation-

Impact: $2.1M annual cost avoidance for ER system; model adopted in 3 other Ontario counties

Four value framework lenses:

B2B (Business-to-Business): Value created between private sector actors.

B2C (Business-to-Consumer): Value created from businesses or service providers to individual citizens.

G2B (Government-to-Business): Value delivered from public sector to business ecosystems.

G2C (Government-to-Citizen): Value delivered directly to citizens by government programs or PPPs.

B2B:

Telehealth providers (e.g., Medtronic) formed service delivery and device leasing contracts.

Data-sharing partnerships with hospitals for better chronic care management.

B2C:

Patients received proactive home-based medical care, improving quality of life.

Chronic disease monitoring lowered patient anxiety and improved autonomy.

G2B:

Reduced hospital burden, freeing up capacity for high-acuity care.

EMS agencies enabled to offer new value streams beyond emergency transport.

G2C:

Access to care for seniors and rural citizens.

Fewer ER visits, reduced ambulance wait times.

Value Framework Dimensions:

Economic Value (EV):

Reduced ER visits and hospital readmissions (>$2M/year).
Functional Value (FV):

24/7 mobile health access, chronic condition monitoring.

Experiential Value (XV):

Dignified, in-home care for seniors.
Social/Public Value (SV):

Health equity in rural regions; reduced healthcare system burden.

Strategic/Ecosystem Value (ESV):

Replicable care delivery model across multiple counties.