DEPARTMENT: FIRE
DEPARTMENT HEAD: CHARLES N. HOOD
COUNCIL DISTRICTS IMPACTED: CITYWIDE
SUBJECT:
Mobile Integrated Healthcare Pilot Program.
SUMMARY:
Update on the SAFD Mobile Integrated Healthcare Pilot Program.
BACKGROUND INFORMATION:
Historically, our 911 service is a catch-all for those who are unable to properly navigate their way to scheduled healthcare. The current EMS structure provides only emergency transport for all patients with healthcare needs regardless of acuity. This process provides acute treatment, but lacks continuity for non emergent conditions and is higher in cost than primary care.
The National Association of EMTs defines Mobile Integrated Healthcare as "The provision of healthcare using patient-centered mobile resources in the out-of-hospital environment that are integrated with the entire spectrum of healthcare and social service resources available in the local community."
On April 1, 2014, the San Antonio Fire Department (SAFD) completed a six month Mobile Integrated Healthcare (MIH) Pilot Program focused on patients with high volume use of our 911 system. The MIH program represents one of the most innovative, progressive evolutions in the delivery of community based healthcare. Through the sharing of data with SAPD the fusion center now acts as a conduit to vet the potential participants for the SAFD MIH Program and we have successfully implemented a model which allows officers from both SAPD and SAFD to recommend candidates to the program from the field. Two teams of SAFD Paramedics have been functioning within their current scope of practice in an expanded role through the use of non-emergent resources in the pre-hospital setting. Their focus has been providing medical assessment and preventive healthcare education tailored to the needs of the individual as well as navigating them through our community medical and social resources. Through the office of the medical director in conjunction with the existing doctors, the MIH program has established treatment plans for the majority of the participants
The pilot program has contacted 55 individuals, graduated 6, and currently has 21 individuals enrolled. There has been a 65.38% reduction of calls for the SAFD by the participants to date, as well as 73.21% reduction of calls for the SAPD by the participants to date.
NEXT STEPS:
· Continue gathering data in order to develop solid metrics in measuring the Institute of Healthcare Improvements "Triple Aim" which has set the three goals of improving the populations' health, the patients' experience of care and to reduce per capita cost of care as it relates to our community and public services.
· Developing data sharing and resources with our SAPD partners
· Continue developing data sharing within the medical community
· Finalize Data Sharing with STRAC and the SAFD once the current draft agreement is approved through city legal.
· Continue develop strong clinical, physician and community partnerships.
· Seeking options of funding to sustain the current phase and program expansion.
· Building an internal participant database that is accessible to the medics while they are out in the community via the vehicle's Data 911 computer terminal mounted in the Mobile Integrated Healthcare units.