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Milwaukee’s Mobile Health Program Shows Benefits of Care Coordination

A three-year-old mobile health program launched by the Milwaukee Fire Department has improved care coordination for the city's most frequent 911 callers, giving them access to care before they need emergency help.

Source: ThinkStock

By Eric Wicklund

- A mobile health program launched in 2015 by the Milwaukee Fire Department has reduced 911 calls from so-called “frequent flyers” by more than 50 percent over the past two years.

Officials say those callers – identified by the department as people with complex health concerns who call 911 dozens of times a year – aren’t calling as often because they’re being seen on a regular basis by specially trained paramedics, who help them before their health issues become serious.

"I see it first-hand. People are getting better," Capt. Michael Wright, the fire department’s mobile integrated health care coordinator for the department, who spearheaded the project, told the Milwaukee Journal Sentinel.

Milwaukee is among hundreds of municipalities across the country to launch a community paramedicine program, which sends trained mobile health workers to the homes of people identified as being the most frequent users of the 911 system. Often called frequent flyers, these callers often have multiple chronic health concerns and problems accessing primary care services, so they wait until their health deteriorates before seeking medical help.

As of mid-2017, some 260 EMS programs across the country were using some sort of community paramedicine program, up from 100 programs in 2014, according to the National Association of Emergency Medical Technicians.

By reaching them before they call 911, community paramedicine programs can provide primary and preventive care in the home, help these people improve their care management, find new ways for them to access needed care, and reduce healthcare emergencies.

Earlier this month, the ambulance service covering New Mexico’s Valencia County announced plans to launch a Mobile Integrated Healthcare (MIH) program in a partnership with Blue Cross Blue Shield of New Mexico and Molina Healthcare, who will be funding the program for its members.

“Each assessment takes about an hour, but can vary in length,” Shelley Kleinfeld, the ambulance company’s MIH supervisor for New Mexico, told the Valencia County News Bulletin.  “It differs from the assessments done traditionally by EMS providers dealing with acute injuries or illnesses. It focuses more on the whole well-being of the individual providing resources, services and education to the patients so they can better manage their health.”

The Milwaukee Fire Department launched its pilot community paramedicine program in late 2015 after a survey of the 62,763 911 calls received that year found that 7 percent, or 4,288 calls, came from the same 100 people.

The 34 paramedics involved in the program receive 200 hours of managed care training from the University of Wisconsin-Milwaukee College of Nursing, in collaboration with the Medical College of Wisconsin. The program was aided by state legislation passed in 2017 that gave paramedics more leeway to provide services in non-emergency situations.

With the program in place, phone calls from those targeted patients dropped 26 percent from October to December 2015, fire department officials said. In 2016, those calls were reduced by 56 percent, and in 2017 the call volume dropped 62 percent.

"The goal is better health and better care at a lower cost," Fire Department Chief Mark Rohlfing told the newspaper. "We're serving the most at-risk citizens in a proactive way.”

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