The New Healthcare Continuum: How Mobile Integrated Healthcare Is Providing New Career Opportunities for Clinicians

Posted on Mon, Sep 14, 2015
The New Healthcare Continuum: How Mobile Integrated Healthcare Is Providing New Career Opportunities for Clinicians

Imagine a healthcare system where emergency medicine and hospital medicine clinicians use advanced mobile integrated healthcare (MIH) technologies to work in tandem with EMS and medical transport to deliver the right care to patients in the right location and at the right time. This new vision of healthcare is becoming reality; healthcare has gone mobile and not only are people staying in their homes longer, they are receiving in-home care for conditions that at one time might have led to a trip to the ER.

For clinicians, this revolutionary approach to delivering care provides opportunities to grow both as physicians and as leaders. And, it allows physicians to practice medicine in an organization committed to changing the face of healthcare.

EmCare and its parent company, Envision Healthcare, are developing solutions that increase the quality and experience of care while simultaneously reducing costs.

Envision Healthcare provides:

  • In-hospital care through EmCare, a leading physician practice management company
  • Medical transportation services through AMR, the nation’s largest medical transportation company
  • Out-of-hospital care focused on disease management and intervention through Evolution Health, a nationwide leader in such services

Evolution Health uses two state-of-the-art Medical Command Centers, one in Texas and one in Florida, to link mobile resources together, integrating them and coordinating them to respond to a patient’s needs. The Medical Command Centers are physician-led medical practices that provide immediate access to licensed medical professionals who can effectively evaluate the patient’s current condition and match and deploy appropriate resources to meet the patient’s needs. Two of EmCare’s physicians serve as medical directors to provide clinical oversight to the Medical Command Centers.

From Emergency Physician to Mobile Integrated Healthcare Leader

One of EmCare’s physicians involved with the Medical Command Center is Jerry Allison, M.D. Dr. Allison was a medical director for two EmCare sites in California as well as a medical director for AMR in San Joaquin. Two years ago, he was promoted to regional medical director for EmCare and was soon appointed medical director for AMR Dallas and the Texas Regional Communication Center. In this role, he trained critical care paramedics and mobile integrated healthcare paramedics (MIHPs).

Evolution Health’s continued growth allowed Dr. Allison to transition into the role of medical director at the Medical Command Center.  As medical director, he provides leadership to physicians, advanced practice providers, nurses and support staff who care for more than 3,000 patients in the Dallas area, including providing mobile lab and imaging services.

Patients from across the country can call either center to:
  • Ask questions about medications
  • Get medical advice
  • Reach their primary care providers
  • Schedule appointments
  • Request an urgent medical evaluation

The centers also offer remote monitoring for certain populations and can provide telemedicine services through on-scene providers and on-call physicians. Transitional care services can help bridge the gap between hospital discharge and the primary care provider, saving thousands of dollars per patient in readmissions.

“Our goal is to deliver the right care at the right time in the right place,” said Eric Beck, DO, MPH, chief executive officer of Evolution Health. “For many patients that place is the home and not the hospital. One of our practices, our transitional care program, is making a big difference across the country by helping reduce avoidable trips to the emergency department. As a physician, it’s gratifying to know we are leading change in the healthcare system.”

Joe Nelson, M.D., an EmCare physician practicing in Miami, provides similar clinical support to the MCC in Florida. Dr. Nelson was medical director for AMR Florida for 22 years and was an EmCare emergency physician for 14 years.

“Throughout my career I’ve encountered patients who need help avoiding a ‘revolving door’ of repeated ED visits and hospitalizations and a declining quality of life,” said Dr. Nelson. “When Evolution Health offered me a chance to participate as the Florida Medical Command Center and MIH Medical Director, I couldn’t wait to start. I believe the MIH concept is the most exciting change in EMS since the early days of the 1970s.”

The Benefits of Mobile Integrated Healthcare

Envision Healthcare-affiliated providers care for more than 15 million patients each year in thousands of communities nationwide.  Its model provides services that improve quality and coordination of care from the home to the hospital and home again – with the objective of keeping patients healthy and out of the EMS system and out of the hospital. This methodology improves clinical outcomes and lowers the cost of care for payers, while simultaneously enhancing the patient’s experience.

The benefits are significant:
  • For healthcare providers, MIH means access to numerous clinical and support personnel and technologies that improve clinical quality and outcomes.
  • For patients, MIH means care is provided in their preferred setting – their place of residence  – leading to improved clinical outcomes and patient experience.
  • For payers, including Medicare, Medicaid and health plans, MIH means reduced costs and improved patient satisfaction.
  • For hospitals and health systems, MIH means a reduction in avoidable readmissions.

Evolution Health successfully collaborated with a multi-facility hospital system to help reduce its preventable hospital readmissions. Managing more than 1,200 patients, Evolution Health was able to reduce the overall readmission rate to 9.6 percent for all patients admitted to service, regardless of diagnosis or payor source.

“I truly think that the synergies of AMR, EmCare and Evolution Health will have a profound impact on patients, EMS and the delivery of healthcare nationally,” said Dr. Nelson. “This is the beginning of something big, and I’m proud to be part of the organization.”

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