The St. Francois County Ambulance District (SFCAD) is working toward a future of fewer ER visits, lower cost of care for patients and higher patient satisfaction with their newest program called Mobile Integrated Health (MIH).
SFCAD’s MIH Program, also known as Community Paramedicine, has been contracted by a major insurance carrier to provide care for patients that may be at risk of rehospitalization for recent treatment of critical conditions.
SFCAD Administrator David Tetrault said the high utilization groups could be suffering from congestive heart failure, diabetes, respiratory issues or other illnesses. He said the goal is the avoidance of readmission and a better quality of life for the patient.
“For many decades paramedics have responded to medical emergencies, sometimes frequently and repeatedly to the same patient, but didn’t have the ability or resources to help the patient avoid repeated 911 calls,” Tetrault said. “Now they do.”
The program allows specially-trained paramedics to follow up with recently-discharged patients to provide care, education and resources to help the patients become better at managing their illness to prevent readmission from occurring.
“As the cost of healthcare continues to rise and the overall health of the population declines these specially-trained paramedics in our community will allow our patients to stay at home, improve their condition, decrease their healthcare costs and have a better quality of life,” SFCAD Medical Director Bruce Harrison said. “This program fills a void within the community and creates an additional choice for individuals who may not need a trip to the hospital but do need additional care.”
“For example, we had a diabetic patient who previously called 911 more than 150 times over the course of two years,” Tetrault said. “Through our program he is now managing the condition, has moved off of disability and is back to work. That alone saved the district many thousands of dollars.”
The State of Missouri currently has approximately 90 licensed specially-trained paramedics known as Community Paramedics (CP) and SFCAD currently has two of them, Tetrault and Paramedic/RN Kent Coleman. The two were required to complete additional training which went above and beyond their traditional paramedic training.
According to the district, Mobile Integrated Health has already shown success across the state with recent statistics showing a 67 percent reduction in emergency department visits, 73 percent reduction in 911 calls, $178,000 reduction in cost of care in the 18 patients studied, 65 percent reduction in hospital admissions, 700 patients now have primary care physicians instead of using emergency departments for their care, and a 98.9 percent patient satisfaction rating.
Tetrault said nationwide examples show a 52.5 percent reduction in readmissions to the hospital for high-risk patients in Texas and in Reno, Nevada, high utilizer volume was decreased 61 percent as patients were navigated away from hospital emergency departments to other healthcare providers.
“The SFCAD Mobile Integrated Health Program will step in before home health care can be approved,” Tetrault said. “It is also designed to be more of a short-term assistance where home health care nursing is more of a long-term program.”
Tetrault said the program is not intended to replace home health care but rather to supplement it and will also be able to accept patients that may be more at risk and have higher potential for health problems.
“SFCAD responds to over 14,000 calls a year,” Harrison said. “This program is going to help us and our patients make some of those calls a scheduled visit instead of an emergency one. As a district we always want to do as much as we can for our patients and this just gives us more opportunities to do just that.”
The district envisions a bright future for the program and is already planning for expansion.
“This is going to assist the people of St. Francois County, and the surrounding region, in obtaining improved healthcare and quality of life while reducing costs, 911 calls and hospital admissions,” Tetrault said. “It’s a win, win for everyone.”