Travis Baker was hired last October by the City of Austin’s Office of the Medical Director and Austin-Travis County EMS.
An Austin-Travis County Physician Assistant is working as a one-man emergency service for people experiencing homelessness and other vulnerable populations.
Travis Baker was hired last October by the City of Austin’s Office of the Medical Director and Austin-Travis County EMS. Since then he has treated hundreds of patients, mainly on the streets, traveling in an emergency response vehicle equipped with life-saving medical equipment.
By meeting and treating patients where they are, at the site of their emergencies, Baker has been able to deliver care rapidly and efficiently, while helping save those who do not require hospitalization from having to make unnecessary and costly trips to hospital emergency rooms. The service has also helped free up ambulances to focus on emergency calls requiring transportation to hospital.
“There are huge healthcare disparities among vulnerable populations and this service is a new way to deliver care that helps bridge that gap,” said Travis Baker. “While I am providing IV fluids or sewing up a wound, I am also able to give my patients information on how they can access support, social services, and ultimately housing.
“I believe we are providing a valuable service for vulnerable populations in the City of Austin, and while in emergency medicine you are always seeing people on one of their worst days, I try to treat everyone I encounter with dignity and respect.”
“By delivering urgent care and emergency care where people need it we can better match resources with needs, reduce costs, and prevent unnecessary visits to the hospital,” said EMS System Medical Director for the City of Austin and Travis County, Dr. Mark Escott. “This new service highlights how Austin-Travis County is leading the way when it comes to healthcare provision for some of our most vulnerable residents.”
Travis Baker describes his role as a ‘paramedic practitioner’ and his appointment is believed to be the first of its kind in Texas. He is now making between 100-120 patient contacts per month, about a third of which are with people experiencing homelessness.
When on call, Baker can expect to receive requests from other ambulance crews and referrals from community health paramedics. Because he has access to the 911 dispatch system he can also self-assign to calls, and respond where he is able to help.
The most common callouts are for wounds, abscesses, skin infections, exacerbations of existing conditions such as asthma and chronic obstructive pulmonary disease, medication refills, and minor injuries such as cuts or sprains, all of which can be handled effectively on the streets.
While many of his patients have less serious needs, some have required and received urgent, live-saving care. Patients who require immediate hospital care are still transported to an emergency room by ambulance.
Although Baker’s post is currently a temporary one, he is confident that the new service will prove its value and one day be in a position to expand its coverage to 24 hours a day.
Other responsibilities of the role include supporting the City’s community health paramedic program, instructing at the Advanced Life Support (ALS) Academy, assisting with paramedic continuing education, and bedside teaching.
Baker’s role complements the work of ATCEMS’s Community Health Paramedic (CHP) Program, which works to address the health related needs and problems of people experiencing homelessness. CHP team members can often be found working with a variety of health care and social service providers such as social workers, doctors, nurse practitioners, police officers and case managers providing medical care and assisting patients navigating the health care system. The overall goal of the CHP is also to connect individuals to education and resources needed to prevent the Emergency Room from being a primary care provider and reduce admissions.