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DENTON – Caroline County Health Department, in conjunction with the Department of Emergency Services, rolled out a long-planned Mobile Integrated Health Program (MIHP) this month. The program aims to create sustainable healthcare solutions for residents, starting with those who frequently use 911.
The MIHP kicked off with its first official visit to a patient’s home on December 3. Officials have planned for one visit per week through the month of December as a “soft launch”, and the program will be in full swing with two visits per week starting in January. Aboard the unit during a home visit are a Community Health Nurse and a Paramedic. They will perform physical, psychosocial, and environmental assessments, connect clients to community services, and reinforce patient education. The Health Department has also partnered with UMMS Shore Regional Health for medication consultations with a PharmD when needed.
The launch marks nearly three years of planning. Caroline County Health Officer Robin Cahall said the idea first took shape after local leaders observed successful mobile health models in neighboring jurisdictions, “We recognize the great work that was being done in our neighboring communities with Mobile Integrated Health… we thought that it would most likely fit here, but we needed to really look at what type of model and what it was that we thought we could do on a smaller scale.”
Cahall said the initial group of healthcare representatives spent years “really focusing on how it could be sustainable, doing the planning portion of it, and realizing that we needed some really good data and evidence to support the initiation of the effort.” With this in mind, the Department of Emergency Services completed a needs assessment. They found that frequent 911 use in Caroline was often linked to preventable factors like gaps in primary care, transportation challenges, and unmanaged health conditions; things that a Mobile Integrated Health Program could mitigate.
The MIHP team has defined “high 911 utilization” as having made five or more 911 calls in a six-month period. There are 73 individuals in the county who fit this criteria, and Emergency Services can refer them directly to the MIHP. The goal of the MIHP is to determine what’s driving this frequent 911 use and intervene at the source – whether it be medical, environmental, social, or a combination of factors – to hopefully decrease unnecessary emergency services usage and/or emergency room visits.
Examples of services the MIHP can provide during visits are pre-coordinated telehealth appointments, medication reconciliations, and home safety assessments. After the visit, measures can be taken to assist the patient with their specific needs. The Caroline County Health Department’s Director of Nursing, Holly Trice, said there are several possible interventions. If a patient frequently falls, the MIHP team could connect them with resources to install grab bars in their home. If a patient needs help with regularly getting medication, the team can provide information on medication delivery and financial aid programs. “Some people feel overwhelmed by what's going on with their mental or physical health,” Trice said, “so we're able to go directly to that individual.”
Funding the program required assembling multiple sources. Cahall explained that the Health Department receives “core funding” from state and county government that can be budgeted for the MIHP, and they have received generous funding from The Caroline Foundation. But like all bodies in Caroline County, Cahall said the Health Department has “gotten really good” at piecing their money together to make a difference.
