Bringing Hospital Care Home: Five Things to Know about Mobile Integrated Health
A high-tech, modern-day house call.
That’s what South Shore Health’s Mobile Integrated Health (MIH) service provides for its patients across the region.
Operated through South Shore Health’s Emergency Medical Services (EMS), the MIH program delivers specialized care to patients in their homes, helping to prevent unnecessary emergency room visits and frequent inpatient re-admissions.
Staffed by paramedics and specially trained EMTs, MIH provides integrated, proactive and comprehensive care supporting a broad range of patient needs, from chronic disease management to post-discharge follow up visits.
MIH first hit the road in March 2020, just as the COVID-19 pandemic was unfolding. The first health-system based program in the state at the time, the progressive hospital-at-home healthcare program started out with a staff of three paramedics, providing care to patients in Weymouth.
Today, the South Shore Health MIH staff includes a team of 18 paramedics and advanced-EMTs, eight advanced practice clinicians (APCs), a nurse, two physician co-medical directors and three coordinators, along with communications center staff, caring for patients in more than 20 South Shore communities.
In just three years, the MIH team has made more than 10,000 visits, providing patients with personalized, expert care in their homes.
To learn more about Mobile Integrated Health, we asked Dr. Kelly Lannutti, one of the program’s medical directors, five questions about this innovative home healthcare program.
How does Mobile Integrated Health work?
The MIH program is designed to provide hospital-level care for patients with acute and chronic health conditions who can safely be treated and continue their recovery at home.
MIH employs a team-based model of physicians, nurses, APCs, advanced EMTs, and paramedics to ensure patients receive the level of care they require with the appropriate medical oversight.
Through the program, specially trained paramedics come to the patient’s home and provide treatment based on a care plan developed by the MIH provider. During the visit, MIH paramedics connect patients to physicians or specialists via telehealth technology and if needed, dedicated clinical and operational staff at the MIH communication center manage remote patient monitoring and outreach.
Although the ultimate goal of MIH is to care for patients at home, if a patient requires more advanced treatment than can safely be provided at home, MIH coordinates transportation to the appropriate care setting.
What chronic conditions and illnesses can Mobile Integrated Health providers treat?
The MIH team can provide treatment for patients with both chronic and acute health problems, including congestive heart failure, chronic obstructive pulmonary disease (COPD), COVID-19, cellulitis, pneumonia, dehydration, urinary tract infections, gastroenteritis and diverticulitis.
MIH paramedics can administer IV fluids, IV antibiotics and IV steroids, coordinate home oxygen and pulse oximeter monitoring, provide nebulizer treatments and order mobile imaging (X-ray) services. If a patient needs a CT scan or other advanced imaging, MIH can coordinate transportation to and from South Shore Health facilities.
MIH paramedics also refer patients in crisis or in need of treatment for behavioral health issues like anxiety or depression, to our partner Aspire Health Alliance.
How can patients access Mobile Integrated Health services?
Access to MIH is based on referral from a primary care or specialty care provider.
Primary care or specialty physicians typically refer patients to MIH that they would otherwise send to the hospital’s emergency department. Nurses conducting telephone triage at outpatient provider offices, help direct patients to the most appropriate level of care and can call MIH directly to request an MIH visit for a patient.
South Shore and Norwell VNAs can also refer home care patients to MIH, when a more acute level of care or evaluation is needed. Additionally, hospital-based providers refer inpatients ready to recover at home to the program.
MIH thoroughly evaluates each referral to ensure the patient is an appropriate candidate for its home-based, hospital-level care. Once accepted, patients receive orientation to the program and have 24/7 access to the MIH, if needed. All follow-up care is documented in the patient’s electronic medical record for the referring provider and the patient’s care team to see.
What are the benefits of Mobile Integrated Health for patients?
The MIH program enables patients to receive hospital-level care in the comfort of their own home, avoiding lengthy waits in busy emergency departments or a hospital admission for treatments paramedics can safely bring to them.
The program is particularly beneficial for patients with mobility issues or without transportation, who cannot easily get to the hospital, urgent care center or their primary care provider’s office when they need treatment.
Elderly patients and those with dementia are also good candidates for the MIH program. Receiving care in the familiar home setting with the support of family and friends has been shown to improve healing.
MIH reduces barriers and closes gaps in the delivery of healthcare by providing convenient access to the medical services patients need to be well.
South Shore Health’s MIH Program is one of the few approved programs in the country by the Centers for Medicare & Medicaid Services (CMS) and exceeds federal safety standards for providing hospital-level care in patients’ homes.
By caring for patients in their homes, MIH reduces common risks associated with hospitalization, including falls and infections. Patients often report being more comfortable receiving their care at home versus the hospital, and MIH patient satisfaction scores are nearly 100%.
VIDEO: Bill K. shares his experience receiving care through MIH
How is Mobile Integrated Health funded and is there a cost to patients?
Initially supported in part through a $10 million gift to South Shore Health funding the Grayken Center for Treatment, MIH continues to be largely funded through donations to support the program and its growth.
Eligible services are billed to patients’ insurance when applicable and MIH continues to grow its network of contracted referral partners. Patients can expect to be responsible for a copay or cost-sharing similar to that of an urgent care visit, depending on their health plan.
There are no cost restrictions to this program based on a patient’s insurance or socio-economic status.