Mobile Integrated Healthcare Practice

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Home Health Partnership

Date of latest update

September 2014

Location

Fort Worth and 14 suburban cities in north Texas

For More Information Contact

Matt Zavadsky,director of Healthcare & Community Integration (MZavadsky@medstar911.org)

Population Served

Patients on home health service at risk for a 911 call; patients on home health service who require after-hours visits

The Need

• Some home health-enrolled patients call 911 without the knowledge of the home health agency for care coordination • Home health agencies are held accountable for ED visits/admissions by referring hospital • After-hours calls for a home RN visit are expensive to the home health agency

The Goal

• Improve the patient’s experience of care, including outcome • Improve population health • Reduce the cost of care • Coordinate care with the home health nurse knowledgeable about the patient’s needs • Avoid unnecessary ED visits • Avoid unnecessary home health nurse visits

Medical Oversight

The home health agency medical director (delegated by the EMS medical director); in the absence of this, the EMS medical director

Key Partners

Klarus Home Care

Personnel

Specially trained mobile healthcare practitioners and critical care paramedics; RN for case management

Funding

Patient contact fee

Plans for Sustainability

Fee for contact

Technology Used

SharePoint EMR; Kinser Home Health EMR (we log in to this)

Program Results

28 patient contacts; reduced ED visits in enrolled population by 36 percent

Resource Center

Mobile Integrated Healthcare Practice



Funded in part by Medtronic Philanthropy.


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