Addressing social risk factors in the prehospital setting: A qualitative analysis of EMS clinician knowledge and perceptions

Emergency Medical Services (EMS) has a unique position of operating between community and formal health care settings. While treating patients within the community and transferring them to a formal health care setting, EMS professionals also observe patients within the intimacy of their home environments and communities, which provides EMS clinicians opportunities to identify Social Risk Factors (SRF) in these settings, opportunities to which other health care professionals may not be privy. Indeed, EMS clinicians could be the “eyes and ears” of the community, a bridge between the community and health systems, and a key collaborator in population health initiatives. The ability of EMS clinicians to bridge the community and formal health care settings can be found in community paramedicine (CPM) and other mobile integrated health care programs; programs that have expanded EMS scope of practice to in-home primary care and preventive services to some of the most underserved populations. Therefore, the capacity to identify and begin addressing SRF exists within current EMS-patient care frameworks, creating the potential to significantly impact the trajectory of patient care.