Mobile Integrated Healthcare and the EMS provider
By Alan Perry
The EMS Agenda for the Future identified the need for Emergency Medical Services (EMS) to seek a broader and more integrated role in the healthcare system. Many variations of that vision have been pursued successfully and are now known as Community Paramedicine or Mobile Integrated Healthcare (MIH). EMS systems are exploring the application of these concepts locally recognizing that all affected parties; EMT’s, paramedics, firefighters, nurses, doctors, EMS agencies, healthcare systems & public health, will want to have input in its design. As a provider I have embraced the concept since I first witnessed its practical application some years ago and began to study it intently. I found that the goals of these programs are consistent with the outcomes I want for my patients and provide the tools I need to improve the performance and effectiveness of my EMS system.
Prevention is a key strategy employed by these programs, reducing or avoiding accidental injury, improving recognition and reaction to strokes and chest pain, and linking your patients with the resources they need to remain healthy and reduce both the severity and incidence of hospital admissions. This is the “low hanging fruit” for us; virtually all of these are within our grasp and require no new legislation, regulation, policy or SOP to get them up and running. Those of us that are also in or around the fire service are well aware of the effect of prevention programs on the incidence and severity of fire events over the last 100 years, greatly reducing the incidence and severity of fire events through education, engineering and legislation. The goals of MIH are very similar, if we can achieve even a small fraction of the success of the fire prevention programs it will be a huge success.
As I think about my daily practice, I would much rather spend a little time at a school or senior living center providing this information, than responding to and transporting someone who is injured or waited too long to call for help. I’m there to help, that’s why I sought this type of work, my goal should be to educate my customers and provide them with resources that will enable them to avoid injury and poor outcomes. Building a new culture within EMS to make this a reality will require changing the way we think about our service delivery and our role as educators. As these programs mature other changes within the health care system are also likely, our role as an emergency resource will remain and our role as educators will expand, beyond that I do not know exactly what our program will look like, but I have a good idea it will be a win-win for everyone.