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Great Mines Health Center

  • Project Title: Mobile Integrated Healthcare (MIH) Initiative
  • Grant Period: FY2021 Rural Health Care Services Outreach Program (Healthy Rural Hometown Initiative Track), 2021-2025
  • Program Representative Interviewed: Doris Boeckman, Project Director
  • Location: Potosi, Missouri
  • Program Overview: Great Mines Health Center (GMHC) is a regional Federally Qualified Health Center (FQHC) established in 2003. Its mission is to improve the health of the whole community through education and patient care. GMHC partnered with the Washington Country Ambulance District to create the Mobile Integrated Healthcare (MIH) Initiative. MIH aims to reduce health inequities, improve population health, reduce healthcare system costs, and improve the patient experience. Services provided have been shown to improve patient health indicators and clinic quality metrics while reducing costs and burden on healthcare providers. This partnership between an FQHC and an ambulance district is unique in the state and allows for increased efficiency and the ability to overcome many access challenges in a rural county.

    The MIH initiative is a community paramedicine program that takes highly skilled emergency medical service (EMS) clinicians into patients' homes and offers reliable, quality care through a unique care team approach. The primary MIH team comprises a community paramedic, community health worker (CHW), and primary care provider. The program allows patients with chronic diseases to receive more frequent medical attention to manage their condition, while remaining at home, thus preventing overutilization of high-cost emergency department medical visits and/or admissions. The MIH vehicle is well equipped to address many different medical needs so that EMS staff can perform ultrasounds, conduct electrocardiograms (EKG) to check for heart conditions, conduct labs, provide medications, and more. The vehicles also have other equipment, such as a refrigerator for storing lab samples and an internet hotspot that allows patients with broadband issues access to telehealth visits from their home. The MIH care delivery model provides many chronic disease management services, including in-home diagnostics, medication reconciliation, telehealth services, referrals for other health services, and in-home infusions of medications.

    The MIH community paramedics are also certified as CHWs. This provides another level of care as they help link patients to community resources. For example, to improve patient engagement and patient satisfaction, MIH offers non-clinical services which can include help with Medicaid or Health Insurance Marketplace enrollment, health literacy, in-home safety assessments, identifying environmental and safety risks, and partnering with the St. Louis Food Bank to deliver food to patients.

    The Rural Monitor article Breaking the Cycle: Missouri Community Paramedicine Program Brings Primary Care to High-Risk Patients has more information about how the MIH program is helping patients in rural Missouri with chronic disease access primary care.

Models represented by this program: