Redesigning paramedicine systems in Canada with “IMPACC”
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
In this perspective, the authors argue that paramedicine's core structure and mandate (i.e., the 9-1-1 system) can innovate to better align with the needs of the public and address the evolving healthcare landscape. Examining Canada as a case, paramedic services are increasingly utilized by the public as a first point of contact for health and social care and often for nonemergent events. Existing emergency-focused paradigms leave the health profession poorly aligned or underprepared to meet the needs of the public and isolated from other healthcare providers and systems. While advances in healthcare policy, infrastructure, and best practices have been proposed to address Canada's healthcare challenges, these advances have yet to sufficiently translate into core paramedicine systems. To illustrate these points, the authors critically examine the alignment of paramedicine models of care with public need, paramedicine's response to government and scholarly advances in healthcare policy and practice, and contemporary public healthcare issues in Canada. Paramedicine's changing landscape is also examined as context for innovation and change. The authors argue that core paramedicine systems be augmented with (not replaced by) an integrated interprofessional primary care paradigm and introduce a novel conceptual strategy, approach, and model of care referred to as IMPACC—Improving Patient Access to Care in the Community, including its guiding principles, conceptual framing, intended outcomes and domains for education. The authors conclude that paramedicine in Canada stands at a pivotal juncture and that the traditional emergency-focused model is increasingly misaligned with contemporary health and social care needs, necessitating a shift toward a more integrated, interprofessional primary care approach. The IMPACC concept offers a viable conceptual blueprint for this transformation, proposing a redesigned 9-1-1 system that incorporates timely primary care services and fosters interprofessional collaboration and integration for differentiated and undifferentiated patients in the community within core paramedicine systems.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it