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In its simplest definition, Mobile Integrated Healthcare (MIH) is the provision of healthcare using patient- centered, mobile resources in the out-of-hospital environment. It may include, but is not limited to, services such as providing telephone advice to 9-1-1 callers instead of resource dispatch; providing community paramedicine care, chronic disease management, preventive care or post-discharge follow-up visits; or transport or referral to a broad spectrum of appropriate care, not limited to hospital emergency departments.
Example 1.
For people enrolled in a hospice program, it can be a disservice not to have this mobile integrated healthcare process in place. For example, if an individual wants to die with dignity at home, but there is an emergency where someone panics and calls 911, the person who is sick will be transported to hospital against their wishes. If 911 had known they had been a part of community paramedicine, community health care, or hospice program the dispatcher can make an informed decision that could save money, time, and respect the person's request.
Example 2.
MIH programs help patients get the appropriate care faster – ideally, the person would be able to connect with EMS and 9-1-1, who could help them navigate to a primary care physician, urgent care center, or other facility if it is more appropriate than transport to an emergency room.
Example 3.
It could also help patients struggling with mental health or substance abuse issues. If these people could be evaluated on the site of the emergency call, they can be transferred to a treatment facility directly. In many of these situations, police end up being the first line of response in mental health and substance abuse emergencies, which are often outside the realm of their expertise. This program saves the patient wasted time in an emergency room, and allows them to be on the route to recovery faster.
MIH programs have major benefits for local communities, saving patients expensive trips to the emergency room or hospital, while also treating them where they are most comfortable.
Community paramedicine is most likely to benefit the elderly or those who have chronic conditions, live in remote areas, or need care at night when doctor's offices are closed. The program is expected to cut healthcare costs and improve patient care overall.
Coordinated care is beneficial for patients, but it’s also a concept that insurance companies actually support. Insurance providers want people to get care from in-network providers, which means care will be streamlined for the patient as well. If coordinating care through mobile integrated healthcare or MIH allows for the patient’s needs to be met without sending them to an emergency department, it is more cost effective for the insurance company. This benefits the insurer by eliminating expensive and unnecessary tests, potentially eliminating an ambulance transport and cutting down on time spent organizing or coordinating between teams.
MIH is provided by a wide array of healthcare entities and practitioners that are administratively or clinically integrated with EMS agencies, while CP is one or more services provided by EMS agencies and practitioners that are administratively or clinically integrated with other healthcare entities.
The community paramedicine model is well placed to facilitate greater integration between paramedic services and health, aged and social services. Public engagement incorporating both participation and inclusiveness can lead to a closer alignment and integration between paramedic services and other services.
Most went on to state that a key purpose of taking a person-centred approach to integrated care is to achieve better outcomes for patients and service users, for example, keeping people in their homes for longer, maintaining independence, reducing unnecessary admissions, improving health outcomes, and quality of life.
