Big boost for West Hawaii paramedicine program

  • Hilo resident Milton McNicholl shakes hands with a Hawaii Fire Department medical specialist during a July 2017 visit that was part of the department’s Community Paramedicine Pilot Program. The program seeks to connect people with community services to decrease the need for 911 calls.

  • Community Paramedicine Pilot Program medical specialists try to talk with patients about frequent ER use in summer 2017. (File photos/Hawaii Tribune-Herald)

  • Community Paramedicine Pilot Program medical specialists attempt to contact a frequent 911 caller in summer 2017. (File photo/Hawaii Tribune-Herald)

HILO — A program aimed at keeping frequent 911 callers in their homes and out of the emergency room received a shot in the arm Wednesday, with a $125,000 grant from the West Hawaii Community Health Center to the Hawaii Fire Department.

The money will be used for the fire department’s community paramedicine program, where paramedics visit elderly, frail and at-risk residents in their homes to coordinate services to ensure their well-being.


Paramedicine programs have proven effective, reducing ER visits by half, according to a 2014 study of programs in the United States, Canada, Australia and the United Kingdom.

Hawaii Island’s program, which began in late 2017, sends paramedics to the homes of the island’s top 200 callers of 911. They encourage individuals, when uncertain if a 911 call is appropriate, to try non-urgent options, when appropriate.

The two professionals — one on the west side and one on the east side — also visit homes referred by Big Island social service agencies.

The fire medical specialists check a person’s ability to get to and from the bathroom, consider the risk of falls and look at the individual’s walking stability and obstacles, such as rugs, that might slip.

The money from the new grant will purchase a vehicle that will initially be kept in Kona, said Capt. Michael Lam, who coordinates the program in West Hawaii. It will also buy wheelchairs, walkers and nightlights and pay for a computer program to help keep track of the clients.

“We need the vehicle for house visits as we check on the kupuna and the various groups,” Lam said.

There’s also money for education and training, he said.

“We’re still somewhat in our infancy,” Lam said.

In 2017, the top caller to 911 dialed dispatchers 82 times in 12 months — summoning emergency personnel an average of once every 4 1/2 days. The estimated cost to respond and transport that single person to the ER was $426,000, including $1,200 per ambulance transport and an average of $4,000 per ER visit.


The Fire Department’s medical personnel are on a quest to see if they can help frequent ambulance riders stay healthier and decrease their need to call 911. After crises pass, they check on frequent ER users and connect the individuals with services, such as the county Office of Aging.

A West Hawaii Community Health Center official could not be reached by press-time Wednesday for comment.

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