Mobile integrated healthcare: Using existing out of hospital resources to bridge gaps in healthcare services

Scott Goldberg, The University of Texas School of Public Health


BACKGROUND: Within the next decade, the United States healthcare system will have a critical shortage of primary care providers. Difficulty in accessing appropriate healthcare services is driving patients to seek care in the emergency department in ever-increasing numbers. EDs are saturated and wait times are increasing. Further, under the ACA institutions are under increased scrutiny and are being financially incentivized based on performance metrics such as readmission rates. Potential solutions abound, but the existing infrastructure of emergency medical services (EMS) systems makes them an appealing option. EMS providers have a constellation of skills that make them uniquely suited to extend primary care and social services into novel healthcare settings, filling gaps in the existing healthcare system. This new service model, referred to as mobile integrated health (MIH), represents a paradigm shift in EMS. Traditional out-of-hospital care takes a reactionary stance, responding emergently to acute illness and injury. MIH shifts this focus to a proactive stance in which healthcare needs are preemptively identified and managed, and emergencies averted. METHODS: The purpose of this topical analysis is to examine the ways in which current EMS systems might bridge the gap between at-risk patient populations and health care services through MIH programs. A review was conducted to identify recent and relevant literature pertaining to MIH. DISCUSSION: Three MIH strategies can be easily implemented. First, MIH can bolster the existing primary care workforce by delivering a range of services, remote from direct physician oversight. Second, MIH programs are equipped to partner with existing institutions to improve the hospital discharge process, reduce readmissions, and maintain long-term health. Finally, MIH is poised to realign services for nonemergent medical conditions, providing accessible, timely, reliable care at the appropriate cost to both the patient and the healthcare system. However, in order for MIH programs to maintain economic viability, reimbursement models must be modified. While published results of MIH pilot programs are limited, reports of early successes are encouraging. MIH programs must engage in self-critical appraisal using established benchmarks and systematic evaluations of MIH programs focusing on patient oriented outcomes are necessary.

Subject Area

Medicine|Health care management

Recommended Citation

Goldberg, Scott, "Mobile integrated healthcare: Using existing out of hospital resources to bridge gaps in healthcare services" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1568983.