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What is Mobile Integrated Healthcare (MIH) and why is it important?


Faced with a growing population and more chronically ill patients, Bulverde Spring Branch Emergency Services must diligently seek ways to address the needs of our community. Success in this arena is handling preventable 9-1-1 calls through a more cost effective manner, one being Mobile Integrated Healthcare (MIH), a unique approach to deliver healthcare to the community members who face challenges with that system. MIH connects people to local resources and organizations to fill the gaps for a healthier and happier community, while reducing the volume of non-emergency requests at the same time.


Our MIH is one borne out of an identified need in our community.  The industry standard MIH program is a restructuring of care, a novel delivery strategy to serve patients in the out-of-hospital setting by providing needs-based, at-home integrated care, but most importantly, it will result in costs lower than traditional health care models.  The MIH approach differs from existing out of hospital care programs in its synchronized multi-provider patient-driven partnerships, defined by local needs and resources. Our key objective has always been to increase access to all health services and to fill the gap until these services are offered in our rural area.


MIH Numbers & Process:


Home visits to seniors and at-risk population increased 281% in 2016.  There were a total of 408 unduplicated patient contacts, an increase of 301 visits over 2015.  Referrals to the MIH program are generated in a variety of ways.  The most common way is through repetitive 9-1-1 calls (2 or more EMS calls in 30 days or 3 or more in 90 days).  Other referrals are generated through the Bulverde Spring Branch Activity Center, Meals on Wheels, local church congregations, and word of mouth.

In 2016, forty six percent (46%) of referrals to the MIH program were for high utilizers. A total of 187 contacts repetitively called 9-1-1 two or more times within a 30 day period.  In 2017 the number of high utilizers has been reduced from 187 to 43 YTD.  If the trend continues, the total number of high utilizers in 2017 will close at 74; a 60% decrease in unnecessary utilization of 9-1-1 through patient education and home visits.


Beyond the positive social impact that is being realized through the MIH program in our community, we also have realized a tremendous economic payoff through cost avoidance measures of handling these citizens through another means other than 9-1-1 services.  


MIH in Action:


An elderly citizen had called 9-1-1 five times in six weeks. Each time the 9-1-1 call came out as assistance for difficulty breathing. Upon arrival of EMS, the patient had been experiencing slight difficulty breathing and was in need of breathing treatments. The patient had recently been placed on home oxygen, been given the appropriate MDI bronchodilators and steroids, and had a home SVN kit. It was determined that the problem was that she was given medications,  home health adjuncts, but no education on their use, nor was her equipment set up properly. The MIH coordinator set up her home oxygen concentrator, and taught her how to use her MDI appropriately along with the SVN kit. After four educational sessions, the patient did not have a need to activate 9-1-1 again.


Through your generous donations to our Annual Gala, Bulverde Spring Branch Emergency Services is achieving success in our community via our innovative Mobile Integrated Healthcare program. Thank you!!


Contact Richard Britz, MIH Coordinator, for more information:

Office: (830) 228-4210

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