Are you an ambulance service interested in Mobile Integrated Healthcare (MIH)? Perhaps you’ve wondered, “How do I integrate MIH into daily EMS operations?” In this guide, we’ll talk about meshing MIH with emergency medical services.
When looking to build mobile integrated healthcare into your daily ambulance operations, it helps to have a plan. The difficulty of getting one of these projects off the ground can vary widely based on your community’s receptiveness to the program. We all know that, regardless of the merit of an idea, some areas just aren’t receptive to new things.
Suppose you believe that your area is ripe for an MIH program. In that case, you can follow along below as we discuss the process for integrating community paramedicine with your everyday EMS functions.
How MIH Works with Emergency Medical Services
The relationship between MIH and EMS is sometimes direct and sometimes indirect. In some areas, MIH programs act independently of emergency services; however, most would say this is not the norm. However, most of the time, EMS and MIH work as one unit.
Here’s what we’ll cover in this article:
- Some of the ways MIH integrates with EMS
- Steps to start integrating MIH into daily EMS operations
- The keys to maintaining a well-integrated MIH program
All right, now let’s look at these points in more depth.
Ways to Integrate MIH With EMS
Sometimes, MIH programs are initiated by the hospital or in collaboration with a clinic. While these programs often work closely with the ambulance service, they are not always directly tied to EMS.
Keep in mind, as we go through this list, that there are many ways EMS can integrate with MIH; however, the ways we’ll discuss here will be the most natural initially and may be the best place to start.
Here are three ways to integrate:
- Start an alternate destination program
- Start a super-utilizer program
- Consider a follow-up program with telemedicine
Note: if you’re looking for information on how to get an MIH program started, then see our guide on how to start a community paramedicine program. That article will give you more nuts and bolts about start-ups – this guide will focus solely on the relationship between EMS and MIH.
Integrating an Alternative Destination Program with EMS Systems
Alternative destination programs allow your EMS agency to address a common problem in rural and urban emergency systems: bottlenecking at the ER.
In the past few years, we’ve all seen the news headlines describing the horrendous wait times ambulances have when dropping a patient off at the emergency department. Unfortunately, many patients being transported to the ER could be treated elsewhere.
You can help mitigate this problem with an alternative destination program by taking patients to urgent care, physician clinics, and rehab facilities.
Integrating a Super-Utilizer Program with EMS
If you’re in EMS, you’ve probably witnessed firsthand how many times a single patient can access the 911 system. These super-utilizers can place a significant strain on the EMS system, and they take away from other patients who might be having more serious emergencies.
Many EMS agencies choose to designate a unit to help these super-utilizers by providing the care they need. These units can drastically reduce the number of times a patient calls 911.
Integrating a Follow-Up Program and Telemedicine
In some areas, EMS teams will provide follow-up calls to patients who have just experienced a significant emergency. Sometimes, these follow-up teams will check in on those patients who have experienced an overdose. These follow-up visits can help prevent emergency recurrences and improve the patient’s chance of receiving definitive help.
Bonus: another way to integrate EMS and MIH is to begin using the powers of modern technology, including telemedicine. Many areas have started using video chat with regular 911 calls. Allowing the physician to video chat into the situation can improve several aspects of care.
For example, a patient who might otherwise refuse care might enjoy speaking over video chat directly with a physician. Also, in a tricky situation, like the decision to activate a stroke or STEMI team, the physician can perform a rapid evaluation over video chat and provide guidance.
Now, let’s talk about how to start with all of this.
How to Start Integrating MIH with EMS
We’ve talked about some ways that MIH and EMS integrate, but now let’s talk about how the program comes together. Every area will be a little different when starting a new program, but some universal principles should help you get started.
Here are the steps to start integrating MIH into EMS:
- Start by contacting the state
- Contact the medical director
- Talk to all parties involved
More information is below on why these steps are essential.
Contact the State
Start by contacting the state office. This serves several purposes. First, it ensures that you’re staying within all legal limits. Every state regulates MIH differently, so know where yours stands.
Second, contacting the state allows you to hear about what’s working and what isn’t working in neighboring areas. If someone else has made a mistake, it’s best to learn from it.
Finally, sometimes, the state will offer grants to get the program off the ground. Funding a program can be one of the initial struggles, so it helps to get some direction from the state.
Contact the Medical Director
After you know the regulations around EMS and MIH, it’s time to begin building out the program. You will need to work closely with the medical director for this process. The medical director will help assess the needs of the community, write protocols, and train paramedics on any needed procedures.
The medical director can also act as an intermediary between EMS and central dispatch, where a good relationship must be established. Finally, having the medical director on board will also help you with the next step – building more relationships.
Contact Involved Medical Parties
If you want to start an alternative destinations program, then it’s vital that you contact all the people who will be involved. If you’re considering transporting patients to the urgent care, then the urgent care will need to help develop protocols to intake patients when an ambulance arrives.
Likewise, suppose you want to transport patients to a local mental health institution. In that case, the organizations should be involved in planning the types of patients who can be admitted to the program.
Contacting local medical facilities can take time, but it’s essential. Strong relationships are the heart of a well-run MIH program. Now, let’s talk about some ways to maintain a program after you start it.
How to Maintain a Well-Integrated MIH Program
How do you maintain an EMS program? You can use a few key steps to ensure that your program stays strong and continues to thrive. Too many people throw a few resources at a program to “see what happens.” To have an effective program, you need to treat it like a garden, providing it with sunlight, fertilizer, and regular maintenance. How do you do it?
Here are three ways:
- Start small: Start with just a small program. Do your best to train personnel to complete the objectives efficiently. Sometimes, the best way to learn is to get started.
- Gather data: After you start, you want to see how your program performs. You do this by gathering data and evaluating what is working and what isn’t. Also, you should keep track of costs and revenue. If you aren’t tracking data on a new program, you’re essentially walking around in the dark.
- Build connections: after you have some excellent data on your program, it will be much easier to show people that what you’re doing is working. Now, you can go to people and say, “Hey, look at this. This works. Want to be a part of it?” Building connections is one of the best ways to continue growing a program.
Now, let’s take a moment to go over a few of our fundamental ideas.
Key Point: Why Integrating MIH with EMS is Important
As EMS moves forward, it will need to evolve to continue meeting the demands of the community. Times are changing, and MIH programs offer EMS agencies the chance to raise their impact and solve many of the problems they face.
Programs that introduce alternative destinations, address super-utilizers, and provide follow-up visits can improve the health of the entire community. EMS agencies should focus on starting small, gathering data, and building connections to integrate these programs. In this way, the MIH program has the best chance of making a significant impact.
Contact Julota to see how their MIH software can help you collect better data, form better connections, and continue to see positive results in all your community paramedicine endeavors.