Ohio City to Launch MIH-CP Program to Cut Down on Frequent Flyers

Dayton Daily News, Ohio

Nearly 300 people in Dayton have called 911 for medical reasons at least 10 times in the last two years, and some called far more frequently than that, including one woman who requested assistance 66 times.

Combined, this relatively small group of patients was responsible for 4,684 medical contacts, which required ambulance runs and regularly resulted in emergency room visits, according to the city.

The city of Dayton and Premier Health have teamed up to try to find alternative ways to serve and provide care to some high-frequency users of 911 and hospital emergency departments.

The new program seeks to connect vulnerable patients with more appropriate services to prevent them from needing emergency care, said Dayton Fire Department Assistant Chief Nicholas Hosford.

“Our overall goal is to reduce the need for these patients to go back to the hospital or to call 911 in a crisis that could have been prevented through more effective care,” he said.

The pilot program, which launches soon and runs through the end of 2022, will be paid for fully by Premier Health.

An evaluation of emergency department data in a recent year at Premier Health’s facilities found that 163 patients accounted for 5,067 visits, according to a service agreement between the city and the health care network.

About two-thirds of those patients live in the city of Dayton and accounted for 3,310 visits, city documents state.

About 30 percent of those patients were taken to Premier’s emergency department by Dayton Fire Department medics, resulting in nearly 1,000 medic runs.

The new Community Paramedicine Program seeks to provide a new and better way to deliver health care services to some community members who use 911 and emergency services at high rates, officials say.

The new pilot program will create individual plans of care for every patient enrolled to try to improve their health and wellness, Hosford said.

Trained program workers will visit patients in their homes to provide education, health assessments and safety checks related to risks like fire, carbon monoxide and falls, he said.

Staff will visit frequent users of EMS and emergency department services to consider health issues, living arrangements, environmental and financial considerations and psychological needs, city documents state.

“Working collaboratively with community partners, this program will enhance patient care and reduce 911 transports where alternate options would better serve our patients and our emergency delivery system,” Dayton fire Chief Jeffrey Payne said in a statement.

Many 911 calls come from citizens with chronic conditions, and the program will try to help patients more effectively manage these medical issues, Hosford said.

Some patients do not have primary physicians, prenatal care, needed medical equipment, medications or transportation or even basic needs like food.

“We’re going to try to connect patients with the appropriate resources throughout the community,” Hosford said.

Some patients have serious conditions. Some have socioeconomic challenges. Some may have difficulty getting medicine or the nutrition they need that would prevent health crises.

A significant number of people use 911 as their medical safety net, and the hope is to proactively provide people with access to health care and social services before issues or emergencies arise, Hosford said.

“We’re not trying to criticize the patients for them calling 911 now,” Hosford said, “but we’re recognizing that we have patients who are calling a significant amount, and we’re trying to see if there are things we can do to help those patients so there’s better and more appropriate ways to help them.”

The pilot program will serve 25 patients at a time who will be identified by Premier Health, the city and others, and patients will be enrolled in the program for up to 30 days.

The paramedicine team will include a paramedic, emergency medical technician (EMT), social worker and will get supervisory and other support from the fire department and Premier Health.

Dayton City Manager Shelley Dickstein said fire department staff and medics sometimes encounter citizens with significant unmet needs, such as one man who was blind and out of food.

“I’m excited about being able to bring services to our community in a proactive way that’s a partnership and collaboration,” she said.

Premier Health has agreed to pay $762,125 to keep the pilot program going for the next three years. The program is open to all qualifying Dayton residents, but data indicate that residents of northwest Dayton are expected to benefit the most, Premier Health said.

Earlier this year, Premier Health officials said the paramedicine team will work with multiple agencies to get patients the services they need, possibly from groups like Meals on Wheels or a prescription-delivery service.

“Collaborating with the city of Dayton to care for patients in their homes is a level of service that we are pleased to introduce to the Dayton community,” said Mary Boosalis, president and CEO of Premier Health in a May statement. “This initiative aligns with our mission and extends our reach in providing quality care.”