2019 AIMHI EMS Innovation Award
Northern Nye County Hospital District

In April 2018, the Northern Nye County Hospital District entered into a professional services agreement with REMSA's Integrated Health Community Paramedic Program.  With the closure of it's only hospital in Tonopah Nevada, and a struggling EMS Volunteer system the Hospital District sought out services to provide a higher level of care to the citizens and visitors to Northern Nye Co. and specifically, the frontier town of Tonopah NV.     

Through innovation and collaboration, the Hospital District worked with REMSA to develop a program that would supplement the existing Nye Co. BLS Volunteer EMS system by co-responding an advanced life support Community Paramedic to all 911 requests for service.  The Community Paramedic can determine the most appropriate patient pathway including; attending to the advanced life support patient in the back of the Nye Co. Volunteer Ambulance during the approximate 2 hr. transport to the closest receiving hospital, initiating direct communication with an air medical resource, or initiating alternative destination transport to the local clinic for low acuity patients.  Additionally, the Community Paramedic operates under an expanded scope of practice, and has integrated into the local clinic with the ability to assist with treatment, and do telemedicine presentations to the trauma center approximately 4hrs. away in Reno NV.  In mid 2019, the program will begin a mobile telemedicine program during times of non clinic availability.  The program also provides in home Community Paramedic patient referral visits and consultation for numerous cases such as CHF, COPD, and medication compliance.  For non emergency services, The Northern Nye Co. Hospital District established 24/7 access to REMSA's dedicated Nurse Health Line number for medical assistance to residents within Northern Nye Co.     

The Northern Nye County Hospital District has been the driving force behind the program.  The goal of expanding the level of care, determining the most appropriate patient pathway, and eliminating long distance transports for those with low acuity emergencies, has proven to invigorate a depleted volunteer EMS System tired of 4 hour transports.  The dedication and willingness of the Northern Nye Co. Hospital District to apply innovation is truly improving emergency and non emergency healthcare to a frontier area struggling to keep their communities healthy and safe.  The nomination of the Northern Nye County Hospital District is truly deserved, and may ultimately pave the way for rural healthcare throughout the country.

About Northern Nye County Hospital District

The Northern Nye County Hospital District was established by the Board of Nye County Commissioners in May 2015 under the provisions of state law NRS 450.550 and including NRS 450.760 through Nye County Resolution No. 2015-17.   

The purpose of the District is to facilitate the provision of accessible health care services to the residents of and visitors to Northern Nye County. The Board of Trustees recognizes that the delivery of health care services is a dynamic process, and the District must utilize its limited available financial resources in the best and most efficient manner possible.

Date of Implementation

• 1/1/18 Nurse Health Line
• 4/16/18 Community Paramedic Program implemented

Number and Demographics of Patients

Since the launch of Community Paramedics on April 16, 2018 to December 31, 2018 the program has remained in service 24 hours per day 7 days a week without interruption.  There has been no out of service hours documented by REMSA’s Community Paramedics.   

Additionally, REMSA’s Community Paramedics have served as the 2nd ambulance provider for Nye Co. EMS in Tonopah approximately 80% of the time.    

• Responses—282 
• Clinic Assist Responses—19 
• Hospital Transports—106 
• Nurse Healthline Calls—310   
• Transport percentage—42% 
• Non-transport percentage—49% 
• Alternative Destination transport percentage—9% 
• Community Paramedic home referral program—1 currently enrolled for COPD   

Patients have benefited, and survivability rates have improved from the increased level of service and advanced life support practice that has become a normal response to all requests for service within Northern Nye Co. and the surrounding areas.