Source Article from USFA Citing Prehospital and Disaster Medicine | Comments Courtesy of Matt Zavadsky
Very nice findings in of a study in Prehospital and Disaster Medicine, and cited by the US Fire Administration.
A couple of interesting statements in the study and the citation:
“As health care systems in the United States have become pressured to provide greater value, they have embraced the adoption of innovative population health solutions. One of these initiatives utilizes pre-hospital personnel in the community as an extension of the traditional health care system.”
“Training in basic disaster response needs should be incorporated into the curricula and community disaster planning should identify how these providers may be able to benefit their local communities.”
Tip of the hat to Mark Babson from Ada County Paramedics in Idaho (and a member of the NAEMT EMS 3.0 Committee) for sharing this information.
EMS Mobile Integrated Health during disaster response
How one community's MIH providers assisted with patient care during severe flooding
Nov. 15, 2018
In many communities across the country, Emergency Medical Services (EMS) provide preventative health care to help reduce unnecessary and costly trips to the emergency room and ensuing hospital admissions. EMS operating in a Mobile Integrated Health (MIH) role help patients with chronic conditions in their homes, divert ambulance calls to outpatient providers, and in some communities, use telemedicine to connect their patients with physicians from their homes.
But what if a disaster should strike? How might MIH providers best assist in the response effort?
A recent study1 was the first to examine the work of MIH providers — Richland County (South Carolina) EMS — during an October 2015 response to severe flooding.
MIH providers were able to meet vulnerable patients' health needs in severe flooding conditions by:
- Reconnecting individuals in emergency shelters with:
- Lost medications.
- Alternative housing or social services.
- Transportation to relocate them with family outside of the affected area.
- Other essential health care.
- Readily identifying to local authorities those patients who required in-person wellness checks.
- Delivering food and water to patients they knew were unable to leave their homes due to a disability.
- Providing uninterrupted power supply for home ventilators, left ventricular assist devices, and other medical equipment.
EMS physicians augmented MIH services during the flood response by performing telephone triage and self-care instruction to patients cut off from EMS. They responded to the field and provided consultation to MIH as needed.
Research takeaways for MIH providers
- Include disaster response in the MIH training curriculum.
- Help patients prepare for disasters by emphasizing the need for an evacuation plan and to safeguard adequate supplies of medications and durable medical equipment.
- Identify ahead of time community members with complex medical needs, such as people who require access to uninterrupted power for life-sustaining medical equipment.
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Utilization of Mobile Integrated Health Providers During a Flood Disaster in South Carolina (USA)
Christopher E. Gainey (a1), Heather A. Brown (a1) and William C. Gerard (a1)
As health care systems in the United States have become pressured to provide greater value, they have embraced the adoption of innovative population health solutions. One of these initiatives utilizes pre-hospital personnel in the community as an extension of the traditional health care system. These programs have been labeled as Community Paramedicine (CP) and Mobile Integrated Health (MIH). While variation exists amongst these programs, generally efforts are targeted at individuals with high rates of health care utilization. By assisting with chronic disease management and addressing the social determinants of health care, these programs have been effective in decreasing Emergency Medical Services (EMS) utilization, emergency department visits, and hospital admissions for enrolled patients.
The actual training, roles, and structure of these programs vary according to state oversight and community needs, and while numerous reports describe the novel role these teams play in population health, their utilization during a disaster response has not been previously described. This report describes a major flooding event in October 2015 in Columbia, South Carolina (USA). While typical disaster mitigation and response efforts were employed, it became clear during the response that the MIH providers were well-equipped to assist with unique patient and public health needs. Given their already well-established connections with various community health providers and social assistance resources, the MIH team was able to reconnect patients with lost medications and durable medical equipment, connect patients with alternative housing options, and arrange access to outpatient resources for management of chronic illness.
Mobile integrated health teams are a potentially effective resource in a disaster response, given their connections with a variety of community resources along with a unique combination of training in both disease management and social determinants of health. As roles for these providers are more clearly defined and training curricula become more developed, there appears to be a unique role for these providers in mitigating morbidity and decreasing costs in the post-disaster response. Training in basic disaster response needs should be incorporated into the curricula and community disaster planning should identify how these providers may be able to benefit their local communities.
Gainey CE, Brown HA, Gerard WC. Utilization of mobile integrated health providers during a flood disaster in South Carolina (USA). Prehosp Disaster Med.2018;33(4):432–435