Mobile integrated health care practice – improving population health through innovative alignment of existing mobile health infrastructure

Fragmentation of care, barriers to access, and outdated delivery and payment models have left patients and clinicians frustrated. Mobile Integrated Healthcare Practice (MIHP) is a conceptual model designed to optimize an existing system of 24/7 triage and transport services. MIHP provides a framework for more timely and appropriate use of community-based healthcare services. Currently, community paramedicine programs have demonstrated remarkable success implementing pilot projects which link public health, emergency medical services (EMS) systems, and hospitals. Some of these program have reduced re-hospitalization rates while others have focused on mental illness, substance abuse and social needs. However, realizing improved health for an entire population requires a more comprehensive and integrative delivery model, with infrastructure allowing patients to navigate the health care system in a way that ensures the most appropriate access to care.

The MIHP framework describes a novel healthcare delivery model that links existing mobile health infrastructure and personnel, communications and information technology infrastructure, as well as a spectrum of other existing resources and personnel in a collaborative enterprise to improve the health of a defined population. MIHP harnesses strategic partnerships among community stakeholders, is driven by a community needs assessment and performance measurements that are patient centered, outcome based, and focused on quality and value.

911-EMS systems are uniquely positioned to support a Mobile Integrated Healthcare Practice. Leveraging the preexisting EMS infrastructure as a health care navigation strategy is sound. EMS currently exists in virtually every community, is potentially linked to all levels of care through its 24/7 capability for mobility and readiness, and is equipped with a workforce that has expertise in planning, coordination and communication in addition to the capacity to assess patient needs and provide appropriate care.

In the MIHP model, a partnership of community stakeholders determines local needs and service gaps. The existing EMS infrastructure is used to guide patient navigation and care, assisting patients to access the most appropriate resources in a timely manner. Additionally, EMS is able to provide scheduled and unscheduled care through primary, secondary, and tertiary interventions. Many EMS systems possess under utilized point-of-care electronic patient record and biometrics systems. When integrated with request-for-service information from dispatch systems, geographic information systems and population health data, the existing EMS infrastructure becomes a powerful tool for launching and supporting this new model. With innovative alignment, MIHP is able to simultaneously improve the quality, outcomes, and value for patients and populations.