News & Updates

  • 28 Nov 2018 8:27 AM | AIMHI Admin (Administrator)

    Source NAEMT Press Release | Comments Courtesy of Matt Zavadsky

    This is VERY cool – TMF is one of the Quality Improvement Organizations/Quality Innovation Networks who work with healthcare stakeholders to improve the quality of healthcare.

    TMF, like other QIO/QINs is contracted to CMS for healthcare quality innovation projects.

    We encourage everyone to participate in this outstanding initiative to advance the EMS profession, and the EMS transformation!

    TMF and NAEMT Partner to Release MIH-CP Learning and Action Network

    Austin, Texas – TMF Health Quality Institute in partnership with the National Association of Emergency Medical Technicians (NAEMT) announces the release of an online learning and collaboration platform aimed at increasing awareness and improving the efficiency of Mobile Integrated Healthcare–Community Paramedicine (MIH-CP) programs.

    MIH-CP is an innovative health care delivery strategy that uses experienced EMTs, paramedics and nurses in non-traditional roles, aimed at improving a patient’s care experiences, improving the health of the population at large, and reducing the per capita cost of health care. MIH-CP practitioners use their skills and experience to provide high quality care in preventive roles, maximizing the use of available health care and community resources.

    The web-based MIH-CP Learning and Action Network (LAN) features several components, including data analytics support for MIH-CP programs, a knowledge network, several educational offerings such as monthly webinars focused on a variety of MIH-CP audiences, discussion boards and MIH-CP Program Profiles. The LAN at will soon also feature a searchable database of existing U.S.-based MIH-CP programs, affinity groups and a Help Desk, which will give MIH-CP stakeholders a resource to request assistance with program development and facilitation questions.

    “Having started my medical career as an EMT, I’ve seen and understand the tremendous value that community paramedicine and mobile integrated health care can deliver to our patients and communities,” said Dr. Russell Kohl, TMF chief medical officer. “Expanding the integration of EMTs, paramedics and nurses into the ongoing care of our community is a common sense approach in improving health and the quality of health care for all Americans. TMF is excited and anxious to help move this community health effort forward through this comprehensive learning and program-development website.”

    About TMF

    TMF Health Quality Institute focuses on improving lives by improving the quality of health care through contracts with federal, state and local governments, as well as private organizations. For more than 45 years, TMF has helped health care providers and practitioners in a variety of settings improve care for their patients.

    Interested parties can contact the TMF MIH-CP LAN Administrator via email at

    TMF Media Contact:

    Emilie Fennell

    Director, Communications and External Relations

    TMF Health Quality Institute


  • 26 Nov 2018 7:51 AM | AIMHI Admin (Administrator)

    Source article from the NY Daily News | Comments courtesy of Matt Zavadsky

    Interesting…  Something many communities are facing….

    Tip of the hat to Ken Simpson, MedStar’s COO for finding this article…


    EXCLUSIVE: Budget watchdogs want city to cut back on fire engines responding to medical emergencies


    NOV 25, 2018

    The city could more wisely spend the $1.1 billion it costs to provide emergency medical services, a budget watchdog group says, in part by reducing the role fire engines play in responding to 911 calls — and then considering whether it really needs all of its engine companies.

    In a new report, the Citizens Budget Commission recommends ultimately reducing the number of engine companies, which for years has been a political nonstarter.

    The suggestion comes as the fire department, which is responsible for responding to medical emergencies, has seen a steady uptick in the number of calls — responding to 1.5 million in 2017, up 36% since 2000. At the same time, the number of fires in the city has decreased. But while EMS work makes up 84% of the department’s workload, it accounts for just 30% of its budget, the report’s author, Mariana Alexander, a research associate at the Citizens Budget Commission, said.

    “The fire department has adequate resources to do its job, and it’s about reassessing how those resources are allocated to match its workload,” she said.

    Fire engines are only supposed to be dispatched to the most serious medical calls, when time is of the essence — because they can often arrive faster than ambulances. But that quick arrival doesn’t always translate into much help.

    While the engines can reduce response time, firefighters can’t provide the same level of care as an ambulance crew can.

    And the engines are much more expensive to staff — with “5 or 6 people on a fire truck, and they’re all paid a lot more than your average EMT or paramedic.”

    “Sending a fire engine doesn’t necessarily reduce your workload, because the ambulance is still needed to transport,” Alexander added.

    Staffing each fire engine costs the city an average of $7.2 million a year — compared to $2.2 million a year on average for an ambulance to make three tours a day.

    “If you closed one fire engine company you could fund 10 additional ambulance tours each day,” she said.

    But closing fire engine companies has been a political third rail for years — Mayor de Blasio even got himself arrested protesting the idea under his predecessor’s mayoralty.

    “It would politically be a very heavy lift for the fire department to do,” Alexander acknowledged.

    FDNY spokesman Frank Gribbon said the engines are dispatched to life-threatening calls such as cardiac arrest, an unconscious person, or someone choking, in addition to responding to fires.

    “Engines also respond to fires and other emergencies, and we do not advocate nor support closing any of them, as the report seems to suggest,” Gribbon said.

    Reducing the role of fire engine companies isn’t the CBC’s only suggestion — it also called for mounting public campaigns to reduce unnecessary requests for ambulances and reducing the focus on response time for minor issues while beefing up the ability to quickly respond to more serious ones.

    “Many of the incidents that the fire department are responding to are not genuine emergencies. These are incidents that either medical care is not needed at all or urgent medical care is not needed,” Alexander said.

    The FDNY said it has been working with other city agencies to try to steer people to other forms of medical treatment when appropriate.

    “We share the CBC’s concern about unnecessary or inappropriate requests for ambulances — and have been working closely with NYC Health & Hospitals, Greater NY Hospitals Association. and the city health care networks that are participating in the Medicaid DSRIP program to ID appropriate alternative pathways for these patients to receive care,” Gribbon said.

    The CBC also takes to task the focus of city officials on response times for all medical calls — arguing that while a quick response is vital in emergencies like cardiac arrest, it is less important for other medical issues.

    “They adopted this kind of cardiac arrest model of responding to medical incidents where time really matters, you have to get there as soon as possible. But that’s not really the case if you sprain your ankle. It doesn’t really matter if they get there in 20 minutes,” Alexander said.

    The city should instead focus on prioritizing lower response times for its Advanced Life Support ambulances — staffed with paramedics — who can provide medicine and have more training. While the number of life-threatening calls have increased, there are fewer Advanced Life Support ambulances and more Basic Life Support ambulances, worked by emergency medical technicians. Alexander posited that was due to the focus on lowering all-around response times.

    “The City Council has been concerned about response times to all incidents not just the most critical ones,” she said.

    “There's no evidence that response time matters for those less critical incidents, where as they really really do matter for the most critical ones.”

    One way to increase the number of Advanced Life Support ambulances — and their response times -- would be to change the way they are staffed. Currently, the ambulances have two paramedics on board. The CBC suggests changing that to one paramedic and one EMT, which would both lower the cost and, spread out more paramedics, who are in short supply, over more Advanced Life Support ambulances.

    Gribbon noted the department has sought to change staffing in the past but was met with roadblocks in Albany.

    “We need state approval to change our Advanced Life Support (ALS) ambulance staffing (currently staffed by two paramedics) to a combination of one paramedic and one EMT,” he said. “We have requested making this change in the past but have been denied.”

    Vincent Variale, president of the Uniformed EMS Officers Union, Local 3621, opposes the idea.

    “I think that’s dangerous,” he said. “I think with the amount of call volume New York City EMS deals with, you need two medics there.”

    The paramedics need to be able to consult with one another and provide a continuity of care, he said.

    “I think what they need to stop doing is trying to cut back on EMS resources in a way where it’s going to endanger the life of the people of the city,” he said, arguing an increase in medical calls ought to translate into more resources.

  • 24 Nov 2018 7:47 AM | AIMHI Admin (Administrator)

    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.

    Study findings

    MIH providers were able to meet vulnerable patients' health needs in severe flooding conditions by:

    1. 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.
    2. Readily identifying to local authorities those patients who required in-person wellness checks.
    3. Delivering food and water to patients they knew were unable to leave their homes due to a disability.
    4. 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.


    Summary information for this article was provided by the NETC Library. You can request access to this research study by contacting the library at

    Explore library services


    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

  • 24 Nov 2018 7:39 AM | AIMHI Admin (Administrator)

    Associated Press Source Article | Comments Courtesy of Matt Zavadsky

    Calumet Park is a community of ~7,500 people in Cook County, IL.


    Calumet Park readies for privatized fire-protection services

    The Associated Press

    November 23, 2018

    CALUMET PARK, Ill. (AP) — Calumet Park officials have hired a private firm to provide fire and ambulance services to spare a tight budget, in a move the village attorney says could become the norm in Chicago’s south suburbs.

    The (Tinley Park) Daily Southtown reports the village board approved a separation agreement this month with its firefighters union and a five-year contract with Kurtz Ambulance Service for fire protection and ambulance services.

    “It’s going to cause a chain reaction in the south suburbs with the communities that just can’t afford to pay the high salaries, the overtime and the equipment,” said Village Attorney Burt Odelson, noting that he was in discussions with three other south suburban communities about outsourcing their fire departments.

    Odelson, who previously engineered privatization in North Riverside that state labor regulators overturned, estimated savings at $500,000 annually.

    Kurtz takes over Dec. 1. It will supply 12 full-time staff members who are firefighters and paramedics in four-person shifts. The village currently has 30 part-time firefighters. Four current village firefighters will join the Kurtz staff.

    Calumet Park will pay $825,000 in the first year. It increases gradually each year to top out at $925,000.

    Mayor Ronald Denson said he never questioned the village department’s quality. But he says with dwindling revenue sources, “We have to make some changes if we’re going to survive.”

  • 21 Nov 2018 12:22 PM | AIMHI Admin (Administrator)

    WNEP Source Article | Comments Courtesy of Matt Zavadsky

    Nice local news story about Geisinger’s program.  The video interview is very cute!

    Dr. Doug Kupas shared the following relating to the program, and Ms. Miller’s perception:

    Although our Geisinger at Home includes physicians, nurses, physician assistants, MIH paramedics, pharmacists, mental health, dieticians, palliative care, and community health workers, the clip did not highlight all of these. It was cool that the patient that they interviewed focused on the paramedics.”


    Healthwatch 16: Geisinger at Home

    JESSUP, Pa. -- It may be an old idea, but a new program is taking off for a hospital system in our area.

    Geisinger at Home is just what it sounds like -- a team of health care professionals treating a patient in his or her own home.

    Angels are all over Jeanette Miller's house in Jessup, but she says some of her favorites wear scrubs.

    "I had to have the paramedics come and shoot that intravenous into my arm and give me the liquid medicine. Thank God for Christine and Dr. Wylie. They really helped me. They were my angels," Jeanette said.

    89-year-old Jeannette is one of the 1,200 Geisinger patients now enrolled in a program called Geisinger at Home.

    "It's not for everyone. We focus on our fragile and medically complex patients," explained Kristine Collins, R.N.

    Jeannette has had heart trouble and fainted once in her kitchen. She's an example of someone who may have a hard time getting medical help on her own, but whose issues can be managed.

    "It's not just for when the patient is sick at home, although that's a great benefit and it benefitted Jeanette here, but we try to keep them as healthy as possible," said Collins.

    "Patients have complex health conditions, multiple conditions, and they have trouble getting out of their home to come to a clinic or a practice to get care. That really was the impetus to get us thinking about a new care model," said Janet Tomcavage, Geisinger's chief population health officer.

    She explains Geisinger at Home started in April. Health officials identify and reach out to people like Jeannette who have a number of hospital stays or ER visits offering an extra layer of care, 24/7.

    And she points out it's a way to cut costs, too.

    "A lot of times patients use the ED for their care and if we can get upstream we can make a difference in outcomes and lower expenses as well," Tomcavage said.

    Officials say Geisinger at Home is not just doctors or nurses. The team can include dieticians and social workers, too.

    That gives them a better picture of what may be happening at home, such as food insecurities, or safety issues.

  • 21 Nov 2018 10:08 AM | AIMHI Admin (Administrator)

    Incidental Economist Source Article | Comments Courtesy of Matt Zavadsky

    Very interesting commentary in the Incidental Economist.  Definitely worth investing the 6 minutes to watch the video.

    Tip of the hat to Gregg Margolis for sharing this find!


    Healthcare Triage: A Lyft to the Hospital: Can Ride Sharing Replace Ambulances?

    November 20, 2018

    By Aaron Carroll

    An ambulance ride of just a few miles can cost thousands of dollars, and a lot of it may not be covered by insurance.

    With ride-hailing services like Uber or Lyft far cheaper and now available within minutes in many areas, would using one instead be a good idea?

    Perhaps surprisingly, the answer in many cases is yes. That’s the topic of this week’s HCT.

  • 15 Nov 2018 2:13 PM | AIMHI Admin (Administrator)

    FierceHealthcare Source Article | Comments courtesy of Matt Zavadsky

    Interesting comments from Sec. Azar, especially with the recent pace of activity from CMS and CMMI conducting conference calls with several EMS organization, requesting SOPs, protocols, outcome measures and ROI determinations for things like Ambulance Transport Alternatives, Community Paramedicine and 9-1-1 Nurse Triage. 

    Even interviewing current payers who are paying EMS agencies for these transformational services.



    Why HHS wants Medicare Advantage plans to pay for home modifications, transportation for seniors

    by Tina Reed | 

    Nov 14, 2018 1:27pm

    Starting next year, Medicare Advantage plans will be allowed to pay for a wider array of health-related benefits including transportation and home health visits, Health and Human Services Secretary Alex Azar said on Wednesday.

    And by 2020, HHS will extend the range of benefits even further to allow MA plans to cover benefits such as home modifications and home-delivered meals, he said. 


    "These interventions can keep seniors out of the hospital, which we are increasingly realizing is not just a cost saver but actually an important way to protect their health, too," Azar said. "If seniors do end up going to the hospital, making sure they can get out as soon as possible with the appropriate rehab services is crucial to good outcomes and low cost as well. If a senior can be accommodated at home rather than an inpatient rehab facility or a [skilled nursing facility], they should be."

    Azar was speaking in D.C. at a healthcare policy symposium focused on social determinants of health hosted by Utah-based Intermountain Healthcare and the Orrin G. Hatch Foundation's Hatch Center.

    He was focusing on the agency's approach to social determinants a day after it was announced that CMS would begin allowing states to cover a broader range of mental health services under Medicaid. Specifically, CMS would consider Medicaid demonstration waivers covering short-term stays for acute care provided in psychiatric hospitals or residential treatment centers in return for states expanding access to community-based mental health services.

    As he spoke, Azar also teased new focus areas coming from CMS' Center for Medicare and Medicaid Innovation (CMMI) for helping vulnerable populations.

    “What if we provided more than connections and referrals? What if we provided solutions for the whole person including addressing housing, nutrition and other social needs all together?" Azar said. "What if we gave organizations who work with us more flexibility so they can pay beneficiaries' rent if they are in unstable housing or make sure that a diabetic has access to and can afford nutritious food? If that sounds like an exciting idea, then stay tuned to what CMMI is up to.” 

    Azar said the moves are part of a broader push under the Trump administration to better harness the flexibility of existing programs to address social determinants that drive up health costs and hurt patient outcomes. 

    “It probably won’t surprise you to hear that this administration is thinking about how to improve healthcare and social services while preserving what is unique about our American system: its decentralized nature and the key role played by the private sector and civil society," Azar said. “But it may surprise you that we are thinking about this very specifically in the context of social determinants of health. We are deeply interested in this question, and thinking about how to improve health and human services through greater integration has been a priority throughout all of our work."

    Medicare Advantage (MA) plans are offered by private companies approved by Medicare and paid by Medicare to cover patients' benefits including hospital and medical insurance.

    While the idea has been lauded by health experts, Kaiser Health News reported few seniors will actually be able to access these changes. Medicare officials estimate about 7 percent of Advantage members — 1.5 million people — will have access, KHN reported.

    Companies offering MA plans both compete for patients and hold the risk for them, Azar said. "They've got incentives to offer benefits that are both appealing to their members and that will bring down healthcare costs whether those benefits are traditionally thought of as health services or not," Azar said. "The key is just that we need to give them the flexibility to do this, which we generally don't do."

  • 15 Nov 2018 2:08 PM | AIMHI Admin (Administrator)
    mHealth Intelligence Source Article | Comments Courtesy of Matt Zavadsky

    Ohio Hospital Using Telehealth to Tackle 911 Calls, ER Overcrowding

    Atrium Medical Center is partnering with the local fire department to launch a telehealth service aimed at local residents who frequently dial 911. The community paramedicine program is one of hundreds popping up across the country.

    By Eric Wicklund

    November 14, 2018

    An Ohio hospital is partnering with the local fire department and Miami University Oxford to launch a telehealth program aimed at the most frequent users of the 911 emergency system.

    Middletown-based Atrium Medical Center and the  Monroe Fire Department are launching a community paramedicine pilot program in the southwest Ohio community, with the goal of bringing connected health services to the region’s most frail and homebound residents.

    Also known as Mobile Integrated Health, the community paramedicine program involves sending healthcare providers – usually paramedics – on scheduled visits to the homes of people who most often call 911. The paramedics perform health and wellness checks using telemedicine equipment, check out the home for potential health hazards and educate residents on community health resources.

    Atrium officials say the program aims not only to reduce unnecessary ambulance calls and ER visits, but to improve the health and wellness of residents who have problems accessing regular healthcare services.

    As part of the program, Miami University students in social work programs will participate in the visits to chart their effectiveness. And the teams will carry a telemedicine kit developed by HNC Virtual Solutions.

    “Not only is the patient’s health and prognosis proactively improved through this revolutionary approach, but healthcare costs will be reduced, and the hospital’s existing healthcare delivery system will be enhanced by freeing up further resources to respond to more significant medical emergencies,” Julian Shaya, the company’s executive vice president, said in a press release. “This virtual solutions tool is a game changer for healthcare.”

    As of mid-2017, some 260 EMS programs across the country were using some sort of community paramedicine program, up from 100 programs in 2014, according to the National Association of Emergency Medical Technicians.

    “Having the opportunity to work with patients in the homes or work sites gives us the chance to be proactive instead of reactive,” Amie Allison, EMS Director for Montana’s Glacier County, said when the Glacier County Community Health Center launched its first-in-the state Integrated Mobile Health Service Program in early 2017.

    Earlier this year in New Mexico, American Medical Response unveiled its Mobile Integrated Healthcare (MIH) program in Valencia County following talks with Blue Cross Blue Shield of New Mexico and Molina Healthcare, which will be funding the program for its members.

    “Each assessment takes about an hour, but can vary in length,” Shelley Kleinfeld, AMR’s MIH supervisor for New Mexico, told the Valencia County News Bulletin.  “It differs from the assessments done traditionally by EMS providers dealing with acute injuries or illnesses. It focuses more on the whole well-being of the individual providing resources, services and education to the patients so they can better manage their health.”

    “When doing an assessment, we perform a risk assessment, needs assessment, fall assessment, and assess patients’ current needs,” she added. “Community paramedics know resources and services that are available in the community and can assist patients to better utilize them. During the needs assessment we can determine if patient is urgently in need of something, whether it’s a food box, water, medications and durable medical equipment. The community medic provider can than help the patients to quickly obtain those resources.”

    In Milwaukee, meanwhile, a program launched in 2015 by the Milwaukee Fire Department has reduced 911 calls from so-called “frequent flyers” by more than 50 percent over the past two years.

    One variation of the service, Houston’s Project Ethan (Emergency TeleHealth And Navigation), launched in 2014, sends first responders with telehealth equipment to the scene of a 911 call to assess the caller before deciding on transport.

  • 14 Nov 2018 9:57 AM | AIMHI Admin (Administrator)

    Learn what high performance, high value EMS means to MedStar Mobile Healthcare CEO and AIMHI President Doug Hooten.

  • 9 Nov 2018 10:05 AM | AIMHI Admin (Administrator)
    Learn what high performance EMS means to AIMHI President-Elect Chip Decker of Richmond Ambulance Authority.

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