During the COVID-19 pandemic, the need for such integration became evident, with programs like UMass Memorial’s MIH initiative addressing emergency department overcrowding and delivering care directly to patients’ homes. These efforts often include chronic disease management, post-discharge follow-ups, and preventive services, all tailored to individual needs. Training for paramedics to deliver advanced care in non-emergent settings, supported by integrated electronic medical records, ensures seamless communication between care teams and patient continuity.
The Role of EMS-Based Mobile Integrated Health (MIH) -CP and Home Health
EMS-based Mobile Integrated Health (MIH) and Community Paramedicine (CP) programs greatly enhance care coordination with home health services. These models are designed to address gaps in healthcare accessibility by providing non-emergency care, reducing hospital admissions, and ensuring efficient resource allocation.
MIH programs also tackle high-utilizer patients, with targeted interventions for individuals frequently using 911 or ED services. Over 60% of public regional EMS agencies incorporate MIH into telemedicine services and patient navigation, enabling real-time consultations and smoother care transitions. Partnerships between MIH programs and home health services focus on preventing hospital admissions and readmissions. These initiatives offer post-discharge care and chronic disease management, reducing strain on hospital systems and improving patient outcomes.
MIH teams significantly reduce the proportion of emergency department (ED) transports. For example, only 28.6% of calls managed by MIH teams required transport to the ED, compared to 74.7% for standard ambulance services, leading to substantial cost savings. On average, MIH interventions cut total costs by more than 50%, making them a cost-effective alternative for addressing urgent but non-emergency health needs. The integration strengthens continuity of care for patients recovering at home or managing chronic conditions, highlighting the synergy between EMS-based MIH programs and home health care.
Key Steps to Establish a Successful Partnership between Home Health and EMS Agencies
- Assess Community Needs
Understanding the community’s unique health challenges and service gaps is foundational for designing an effective partnership between home and EMS-based Mobile Integrated Health(MIH).
How to Implement:
- Conduct surveys or focus groups with patients, caregivers, and healthcare providers.
- Analyze health data, including hospital admission rates, EMS call volumes, and prevalent conditions. What health conditions are most prevalent? Which populations are underserved?
- Evaluate existing home health services, EMS capacities, and gaps in coverage.
- Example: In rural communities, EMS and home health collaborations often address limited access to preventive care, focusing on mobile clinics and telemedicine services. Determine high-utilizer patients and frequent 911 callers who could benefit from proactive home health interventions.
A well-documented needs assessment ensures that both agencies can allocate resources effectively and develop tailored programs that address local health challenges.
- Define Partnership Goals
Clearly defined goals provide direction and ensure all parties understand the purpose of their collaboration. Goals should align with improving patient care and operational efficiency.
How to Implement:
- Identify short-term and long-term objectives, such as reducing 911 calls for non-emergent cases or improving post-hospital discharge care.
- Set SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound).
- Shift the focus to proactive care at home for patients with chronic illnesses or post-discharge needs. Prioritizing the quality of life, reducing health complications, and improving patient satisfaction.
- Example: A shared goal might be to decrease hospital readmissions by 15% within the first year of collaboration.
- Develop Mutual Protocols
Protocols establish a clear roadmap for handling patient referrals, joint interventions, and emergency versus non-emergency care scenarios.
How to Implement:
- Develop guidelines for when and how EMS can refer patients to home health services. To address practical challenges, these protocols should be co-created with leadership and frontline staff input.
- Create escalation protocols for home health providers to request EMS for urgent needs.
- Standardize communication methods, such as shared dashboards or secure messaging systems.
- Example: EMS teams might use checklists to determine if patients can be safely referred to home health instead of transporting them to the hospital.
- Data Sharing and Interoperability
Seamless access to patient records ensures continuity of care and prevents errors or duplication of services.
How to Implement:
- Adopt interoperable EHR platforms that comply with HIPAA regulations.
- Establish secure data-sharing agreements to protect patient privacy.
- Provide EMS teams access to patient care plans stored by home health providers.
- Implement mobile apps or portals that allow teams to instantly share updates, track patient progress, and request additional resources.
- Example: A paramedic responding to a 911 call for a chronic disease patient could access their care history and collaborate with the home health nurse to adjust treatment plans.
- Training and Cross-Disciplinary Education
Training enhances collaboration by building trust and understanding between EMS and home health professionals, reducing miscommunications.
How to Implement:
- Hold joint workshops to educate EMS teams on chronic care management and home health providers on EMS protocols.
- EMS and home health teams should know each other’s scopes of practice, limitations, and workflows.
- Include simulation exercises that involve both EMS and home health roles.
- Example: Paramedics might learn wound care techniques commonly handled by home health nurses, while nurses could gain insights into emergency triage. Conduct collaborative drills to prepare for common scenarios, such as managing a patient with congestive heart failure at home.
- Secure Funding and Address Reimbursement Needs
Financial sustainability is critical to maintaining and expanding integrated care programs. Funding remains a significant hurdle.
How to Implement:
- Explore funding through Medicare’s Emergency Triage, Treat, and Transport (ET3) model, which supports innovative EMS care approaches.
- Negotiate shared savings agreements with insurers or apply for federal grants.
- Advocate for policy changes that expand reimbursement eligibility for integrated services.
- Example: Partnering with accountable care organizations (ACOs) or managed care plans can align incentives for reducing costs and improving outcomes. Many EMS agencies successfully secure funding for mobile integrated health (MIH) programs through state Medicaid waivers.
- Track Key Performance Indicators (KPIs) and Use Data Insights
Measuring success helps refine the partnership and demonstrate its value to stakeholders.
How to Implement:
- Define KPIs such as response times, hospital admission rates, patient satisfaction, and cost savings.
- Measure how often MIH/home health interventions prevent unnecessary ED visits. Regularly review reports and adjust strategies based on data insights.
- Assess the quality of care from the patient’s perspective. Share results with stakeholders, including patients, to maintain transparency and trust. Track metrics like reduced exacerbations of chronic conditions or faster recovery times.
- Example: In one study, MIH reduced emergency department visits by 50%, showcasing its impact to funders and policymakers.
Mobile Integrated Health(MIH) in EPR Fireworks
The Mobile Integrated Health (MIH) module in EPR Fireworks is designed to help paramedics and community paramedics manage chronic diseases and deliver home-based education to reduce hospital admissions and readmissions. This feature-rich module simplifies client management by allowing users to filter and view clients based on criteria such as visit dates, conditions, or types, including congestive heart failure, diabetes, chronic kidney disease, or overdose.
With detailed client records at your fingertips, the EPR MIH module provides access to personal information, visit history, medications, and activities. It also supports storing and managing essential documentation and attachments for seamless care management. Efficient scheduling and tracking of visits are made possible, while custom filters enable prioritization of care based on specific needs, ensuring no patient is overlooked.
Comprehensive contact management is another key feature, allowing coordination with family members, caregivers, and other key contacts to optimize patient care. EPR Fireworks’ MIH module is your solution for enhancing chronic condition management and improving patient outcomes through proactive, well-organized, home-based care.
Ready to get started? Contact us today to activate this module or to learn more.
