Anyone responsible for emergency medical services (EMS) has likely seen first-hand the need for mobile integrated healthcare with their own eyes but has faced data and system barriers that make it hard to implement an MIH program. That was the case for King County in Washington, home to the City of Redmond.
“The county gave us six months to develop the MIH program,” said senior paramedic, Dana Yost, with Redmond Medic One. “Like most EMS, our data systems were incident-based, but with MIH we needed to keep track of who we saw, how many times and what we saw them for. We also needed to be able to share that information.”
Programs like mobile integrated health and community paramedicine expand the role of EMS.
MIH programs take a proactive, whole-person approach to keeping the community healthy. Along with its close cousin, community paramedicine, MIH programs provide healthcare, care planning and connection to needed services.
King County’s MIH program is operated by Medic One and local fire departments in partnership with King County Emergency Medical Services. Specially trained firefighter EMTs and paramedics help residents in northeast King County help those who tend to need emergency services, especially people with chronic conditions and older adults, to prevent emergencies or plan ahead in case of one.
MIH programs work only if they have access to the right data and information.
These valuable services are possible only because the MIH program was able to find a system that let them collect and share data. But, the learning curve was steep and it was slow going at first.
Learning about Julota from a similar program in Colorado Springs made all the difference.
“Julota has worked hard to create a data-sharing program that works for us,” said Yost. “They have created bridges with other software vendors that serve different parts of the healthcare system. One software that is focused on hospital emergency visits, and Julota receives data from that source so we are alerted to when one of the patients we serve has gone to the emergency room. Another software collects data for 911/EMS, and Julota gets data from that source. It also integrates EHR data from hospitals.”
With the right data-sharing, Redmond can meet the needs of older adults with assistance and referrals.
MIH and community paramedicine services are perhaps best known for serving people with chronic substance use problems and other high utilizers of the 911 system. But, the true needs of each community are different. In Redmond, MIH used its data to serve one of its populations with the greatest needs: older adults.
“We have a large elderly fall program,” said Liz Downs, a paramedic who now leads the MIH program. “We partner with agencies that help older adults with this issue, like Aging and Disability Services and King County Falls Prevention. “Julota is HIPAA-compliant, which allows us to make referrals and send patient information to all the agencies we work with.”
The MIH program now has the ability to track who is at risk for falls so they can reach out proactively. The program doesn’t just make referrals: specially trained MIH staff can also do a safety inspection of someone’s living area and give suggestions for reducing falls.
With its robust referral system, MIH can refer older adults to a number of community services, including food assistance and Medicaid. MIH staff help older adults complete the applications, which can be long and complicated, to ensure that older adults get the services they need.
Information-sharing allows the MIH program to do care planning with people who have complex chronic conditions.
With better access to data and a platform for data-sharing, the MIH program has been able to expand its services to include care plans for patients with complex medical problems. Because these patients are likely to need emergency services at some point, the MIH program works with patients and families to create a care plan.
Patients and families can give this one-page document to whatever EMS team arrives at the scene, giving the team the ability to respond appropriately to situation quickly and effectively. Patient data for this program, along with the care plans, are tracked within a module of Julota.
Data-sharing platforms open the door for EMS to make healthcare more coordinated and efficient.
In a time when healthcare costs continue to rise, communities are looking for ways to reduce expenditures and make the system more efficient. EMS personnel have often known who is at risk for future problems, but before the MIH program and the ability to track patients across time and systems, they were not able to do anything about it.
Now, rather than waiting for a 911 call from an individual, Redmond EMS personnel can proactively visit them. They can, for example, visit patients between discharge from the hospital and a follow-up appointment—a particularly vulnerable and important time to prevent costly re-admittance to the hospital.
Data-sharing brings programs like King County’s MIH to life, enabling them to realize the vision they have for EMS to create better health in their communities.