Fire Department: Mobile Integrated Healthcare

The Challenge: 

Did you know that firefighters are trained EMTs and spend most of their time responding to non fire-related 911 calls? One of the most common calls firefighters respond to are lift assists. If someone falls, they might not require an ambulance service but rather someone to help lift them up. In those interactions, it’s often discovered that the individual might have additional needs at home that go beyond the initial call like identifying trip hazards in their environment or additional social/mental health needs. Obviously, sending a fire truck and firefighters to these situations is overkill and doesn’t make sense. 

 

The Idea:

Mobile Integrated Health (MIH) is a patient-centered care model that allows the MIH unit to meet patients where they are; whether that’s at a residence, at a nursing home, or on the street. The Community EMTs go out before or after a 911 call to visit the patient to address their level of need or any gaps in care received. 

 

The range of situations that first responders address do not always require a sworn police officer or firefighter to respond. MIH responders work in those gray areas to allow for police and fire to respond to the scenarios most appropriate for their skill sets. The Bloomington Fire Department’s MIH Community EMTs are advantaged with diverse career backgrounds as EMTs and victim advocacy. 

 

MIH units coordinate care to improve quality of life, prevent additional nonemergency calls, and follow up accordingly. Responders follow up with callers to ensure that any issues are addressed holistically and in the long term. 

 

“We not only get to do health assessments, but we also get to see it through. We make sure that they get the help they need long-term instead of just responding to emergencies.” - Shelby Wood, Community Care Coordinator

 

The Cost:

While there is no charge to patients for this service currently, the program has incurred some costs for outfitting the MIH team members with uniforms, offices, emergency medical equipment, vehicles, portable radios, and IT equipment. Total costs come to $103,800 for personnel, equipment, and office supplies.

 

The Benefits:

Prior to the implementation of the Community EMTs, multiple residences had been identified by BFD for requesting frequent non-emergent assistance. The volume of repetitive non-emergent 911 calls has significantly decreased since the program began. Due to this program and the proactive efforts of the emergency operational crews, patients who call 911 for a non-emergent call are referred to the MIH quickly, sometimes after the first patient interaction. Due to this quick intervention, the number of 911 ‘super-users’ has dramatically decreased and the patients are getting the access to a multitude of social service organizations and medical care options within the community. 

 

 

The graph above highlights several patients that had called 911 for non-emergent reasons, such as a ‘lift assist,’ which is incident type ‘554’or ‘Assist Invalid.’ These types of calls were the first priority of the MIH program once it became established in October of 2022. The demand for an emergency apparatus responses decreased significantly. Note that although Patient #1’s calls increased initially, there have been no calls for an ‘Assist Invalid’ in 2023.

 

“We never want to deter someone from calling 911 if they need it, but if it’s a non-emergency situation where we don’t necessarily need 911, we want to step in to help prevent those calls.” - Shelby Wood, Community Care Coordinator

 

Many of the patients assisted by the MIH program received the much needed ‘gap care’ which has improved their overall quality of life while easing the workload of the emergency operational crews. The team has received over 100 referrals, currently has over 40+ open patient cases, averages five visits per patient, diverted multiple 911 calls, and has ‘graduated’ several from the program.

 

“Lives have quite literally been saved by the interventions of the MIH team” - Deputy Chief Tania Daffron

 

This program has been a success on many levels. Community members who were unaware of the assistance available to them were ‘falling through the cracks’ in the medical system. Now, those individuals are getting the ‘gap care’ they need to improve their overall quality of life. 

 

“While taking some of the workload off the emergency crews has boosted department morale, it has also made the crews more proactive and involved in improving the lives of community members the department proudly serves” - Deputy Chief Tania Daffron

 

Metadata

Department(s): Fire Department

Department Point(s) of Contact: shelby.wood@bloomington.in.gov

Partner(s): Trisha Rademachir, Lily Blackwell, Shelby Wood, Amber Stewart

Partner Point(s) of Contact: 

Type of Innovation: New Service

Date Implemented: May 2022