MIH-Playbook1

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Table of Contents

What is Mobile Integrated Health (MIH) /Community Paramedicine
Mission Statement
Organizational Chart
Job Descriptions (Find a different word)
NCEMS Paramedic Scope of Practice
Clinical Policies, Procedures, Protocols
Operational Policies, Procedures, Protocols
Orientation/Training
Continuing Education
Service Lines
Visit Types
EPIC Scheduling
Technology
Equipment
Pharmacology Formulary
Paramedic Daily Workflow
Fleet Services
Dispatch
Proforma
Billing
Program Recognition and Future State

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Mobile Integrated Health (MIH)

Mobile Integrated Healthcare (MIH) is the provision of healthcare using patient-- centered,
mobile resources in the out--of--hospital environment. ... network/patient--centered medical
home, using telemedicine technology when appropriate and feasible.

Near the end of the 1990s, a handful of EMS agencies began experimenting with new
“integrated healthcare delivery systems,” working with previously distinct previous distinct
healthcare delivery entities like hospitals, physician groups, and nursing homes. This
movement’s vital component focused on preventative efforts like modifying illness and
injury risks, providing acute illness and injury care and follow-up, and better treat chronic
conditions. EMTs began utilizing telemedicine and alternate transport destinations to reduce
the number of unneeded ED transports, saving time and resources for both the patient and
providers. Today, hundreds of EMS agencies across the nation are partnering with local
health providers as well as mental health and social services providers to navigate patients
to the right level of care. By leveraging the Paramedics expertise and skills in the field, time
and money are saved by getting the patients the get the care they really need more quickly.

What are the benefits of MIH?

The MIH approach delivers numerous benefits along the healthcare spectrum for providers,
payers, and patients. These include:

 Reducing Unnecessary ED Visits: Emergency Departments are chronically
overcrowded and overburdened. Ideally, only the most severe cases needing
emergency care end up in the ED beds. Additionally, mental health-related issues or
non-life-threatening conditions could be redirected to other local facilities. Patients
can receive more appropriate care in a timely fashion, rather than sitting in the ED
waiting for a referral and additional transport.

 Reducing Hospital Readmission Rates: Patients with chronic conditions, or those
sent home after a procedure, can benefit from community paramedics to improve
their health and wellness at home. From follow-up visits and calls to assistance with
prescriptions and medication schedules, paramedics can ensure that patients
understand discharge instructions and are prepared to follow them correctly.
Additionally, paramedics can offer observations from a patient’s home and lifestyle –
a perspective physicians typically do not have – that provide clues into readmission
causes.

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 Saving Time and Money: While health care providers want the best outcome for their
patients, it’s undeniable that they are trained specifically to deliver care for a defined
need. Seeing a patient that will need to be sent somewhere else – or one that truly
needs ongoing help rather than emergency services, for example – does nothing but
waste time for the patient and the provider. Getting the right care at the right time
and the right location is more efficient for all involved and leveraging the perspective
of the EMS agency onsite is invaluable in these efforts. By allowing EMTs and
paramedics to make recommendations can literally save millions of dollars in
expensive ED visits, transports, and consultations.

 Can Assist in a Pandemic: Never has the value of MIH been more apparent than in the
fight against COVID-19. Patients at home begin to experience symptoms and are
understandably scared and confused. They call 9-1-1, not knowing what next steps to
take to preserve their own health and avoid spreading to others. Rather than
transporting thousands of potential cases to the ED, MIH/CP can assist in providing
more effective call screening, in-home testing, vaccinations, and even counseling and
monitoring to ensure that only the most severe cases end up in the ED based on
genuine need. This not only lightens the load on ED providers but can reduce the
virus’s spread by reducing the number of people sitting in an ED bed (some of whom
may not be COVID-positive) and ensuring that family-members are appropriately
tested and treated before going out into the community.

The Future of MIH Programs:

As the integrated health approach continues to deliver cost-savings and positively impacts
communities, these programs are gaining traction across the U.S. MIH-CP programs tend to
be a public initiative and often rely on grant funds, EMS budget, or local jurisdiction.
However, more and more agencies, payers, and government bodies see the benefit of
reversing the fee-for-service model that tends to incentivize the transport and admission of
most calls, even when alternative destinations might be more efficient.

Ensuring that EMS agencies will be reimbursed for delivering the right care – even if that
means not transporting to the ED – payers are helping reduce waste and improve the long-
term health of those they cover. EMTs and Community Paramedics are given more ability to
offer insight and recommendations on the care of those they see regularly and those they
encounter in an emergency.

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Scope of Service/Staffing Plan

Atriums Community Paramedicine
Community Paramedic Staffing Plan

Purpose:

The purpose of Atrium Health’s MIH is to provide a comprehensive MIH program to
the citizens of North and South Carolina which are enrolled in post discharge
programs supported by Atrium Health.

Hours of Operation:

Atrium Health’s MIH is available between the hours of 0700 and 2100 seven days a
week.

Scope of Care:

 Atrium Health’s MIH provides Basic and Advanced care for patients enrolled in
post discharge programs supported by Carolinas Healthcare System.

 Atrium Health’s MIH can provide service to all age groups and patient
populations.

 Atrium Health’s MIH can provide a broad range of services to include the
following:

 Basic and Advanced Life support measures.
 Integrated networking with the outside and Healthcare agencies to
provide social support for patients and families.
 Patient and Caregiver educational support as needed and requested.
 Virtual Visits
 Home Assessments
 Medication Reconciliations

All medical decisions will be based upon the patient's illness and acuity, under medical
direction utilizing the Community Paramedic policy and procedure manual, clinical protocol
manual and online medical control.

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Mission Statement

Mission Statement

The mission of Atrium Health’s Mobile Integrated Health (MIH) program shall be to create
and operate a comprehensive MIH program to provide safe, quality patient care to those in
need of a community-based healthcare program; and participate in related services,
including education and research opportunities for the benefit of the people it serves.

Strategies

The strategies used to accomplish this mission include:
 To provide the highest quality patient care.

 To maintain and protect the continuing financial viability of the system.
 To identify, plan and respond to new and emerging health care needs within
the mission and capabilities of the system.
 To provide the most pleasant and caring environment possible for patients
and their family members.
 To communicate to the public, the goals, needs and achievements of the
system and its impact on the community.
 To provide an organization structure that will facilitate the achievement of
present strategies and provide maximum flexibility for future changes.
 To attract and retain the highest quality management and personnel and to
create an environment which fosters their personal and professional growth.
 To maintain strong and continuous contact with other leaders and leading
institutions in the health care field.
 To provide quality documentation in EMR.

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Organizational Chart

M ed ica l Vice President Med ica l
Di rec to r Jason Schwebach Di re c to r

Dr. Stephen Constantine Dr. Stephanie Murphy

Assistant VP

Robyn Neely

MIH Director
Eric Claflin

Management Manager of MIH Supervisors
Associate Operations
Amanda Williams James Fraccola, Benjamin Graham,
Chelsea Lennon Brittani Williams
Management
Associate
Savanah Woodruff

CP Lead and Paramedic Staff.

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MIH Team Job Descriptions

Operations Manager (1)

Job Summary: Directs and oversees a variety of Mobile Medicine operations including
clinical and logistical team members in designated divisions of the department.
Ensures that all regulatory agency requirements are met.
Ensures that Mobile Medicine area of responsibility is available for 24/7
emergency response as needed.
Monitors the performance and productivity of all direct and indirect reports and
ensures that all personnel function within their scope of practice as defined by
N.C. regulations.
Reviews and evaluates work methods and procedures for best and most efficient
practice. Develops internal and external partnerships to ensure success in areas of
responsibility.
Assist with contract development for Mobile Medicine assets.
Develops and implements administrative and managerial initiatives and
introduces action plans to accomplish System objectives.
Assess current industry trends and innovations and anticipates and plans for
organizational needs to remain competitive.
Provides primary oversight of development, implementation, monitoring, and
enforcement of operational protocols and procedures.
Oversees and participates in the development and administration of approved
annual budgets in conjunction with departmental director. Additionally, provides
feedback / recommendations for capital budgets.

Management Associate (2)

Job Summary: Collects, evaluates, analyzes, and coordinates the review of financial
information. Assists in strategic business and financial planning, reimbursement, and other
management operations. Collects, reviews, and analyzes data for system department
leadership. Provides support and personal computer expertise for the department as
required.
Performs analytical related projects requested by leadership using available internal and
external databases as appropriate. Serves as liaison/leader in related projects for
department. Prepares necessary reports for department.
Maintains adequate knowledge base of healthcare trends, reimbursement, and related
regulations. Maintains an adequate knowledge of state-of-the-art analytical tools such as
microcomputer software and applicable data sources. Manages several projects at one
time.

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Paramedic Supervisor (3)

Job Summary: Assist with overseeing and supervising a variety of Mobile Medicine Paramedic Day
to day operations. Will still function independently as a member of the Mobile Medicine Paramedic
team when needed and is responsible for the care of ill and injured patients cared for within various
departments. Provides patient care while promoting safety and efficiency of Mobile Medicine
operations. Performs under the direct supervision of the Medical Control Physician, either by
continuous radio contact or direct consultation, providing a professional standard of care and
performing any protocols and/or procedures approved for use by Mobile Medicine. While specific to
Mobile Medicine service line, may lead paramedicine teams within Community Paramedicine, MCA,
Fleet Services, and Med-1, etc. Supervises day to day Mobile Medicine Paramedic operations

Paramedic (37)

Job Summary: Functions independently as a member of the Mobile Medicine Paramedicine team and
is responsible for the care of ill and injured patients cared for within various departments. Provides
patient care while promoting safety and efficiency of Mobile Medicine operations. Performs under
the direct supervision of the Medical Control Physician, either by continuous radio contact or direct
consultation, providing a professional standard of care and performing any protocols and/or
procedures approved for use by Community Paramedic. The practice of MIH-CP is focused on
longitudinal assessment, participation in an existing, multidisciplinary, interprofessional treatment
plan, and communication with and referral to other members of the treatment team based on
changing patient needs. Essential Functions

MIH Educator (1)

Job Summary: Responsible for day 1 departmental orientation and training of new hire teammates.
Serves as a mentor for new hires. Maintains department required certifications and compliance of
certifications Work with appropriate agencies to ensure education is on track. Research current trends
and evidence-based medicine. Provides continuing education opportunities which are appropriate for
MIH and NRP. Verify competency of skills. Arrange for end of orientation “check offs” with peers and
medical directors. Update and facilitate use of iOPs 360. Works to develop of plan for use of grant funds
to present to Operations Manager

MIH Outreach Liaison (1)

Job Summary: This position requires staff member to perform duties as Paramedic
Leader/MIH provider in addition to outreach responsibilities. Supports outreach department
with strategic planning and marketing activities to cultivate new and existing business in
assigned referring agencies, departments, and outside EMS customers. Works to provide
support for established relationships within Atrium Health departments, local EMS, Case
Mangers, and other customers.

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NCEMS Paramedic Scope of Practice:
https://ncems.org/pdf/NCCEPandNCMB-List-

Combined-Revised.pdf
MIH Clinical Polices, Protocols and Procedure

To be added once approved by medical directors

MIH Operational Polices

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Orientation and Training

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MIH New Paramedic Orientation

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Continuing Education

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Continuing Education Requirements

Education or Required by Why Possible
Certification Alternative
CAMTS, AH
BLS CAMTS, AH
CAMTS, AH
ACLS CAMTS, AH

PALS

Advanced certification
(CP-C)

National Registry for MIH, SCDEHEC EMS credentialled providers
EMS credential must be licensed in both NC and
SC for state regulations. SC is a
Sim lab CAMTS NR state.

CEVO and driving AH transportation CAMTS requires either clinical
experiences or simulation. in lieu
of that. The scenarios used in sim
lab also will account for
additional assessment/ manage
met of the patient; along with;
categories from low-
volume/high-acuity situations,
other reasons derived from on-
going QA through the year.

Driving awareness yearly based
on insurance purposes. Online
class every 3 years. Driving
checkoff yearly.

Sleep deprivation CAMTS

Just Culture CAMTS

Stress recognition & CAMTS
management

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Safety briefs- Vehicle, CAMTS, MIH Annual safety training
self and patient. CAMTS, MIH, AH
Bi-annual skills Many skills are outside the
AH- meets regulatory normal scope of practice per
ACE modules needs discipline, are done infrequently,
AH EMS requires skill competency
Fit test AH validation
Flu vaccination The list is continually changing.
Make sure to check for
additional modules being added.

Explanation of Annual Requirements

The goal of the Mobile Integrated Health Education Team (Medical Director, Clinical
Educator, and Preceptors) is to provide as many learning opportunities as possible for each
teammate within the scope of their practice as allowed by the department’s budget. The
goals are driven by regulatory, CAMTS, and departmental needs. Individual professional
development requirements are a personal responsibility to ensure your respective
certification requirements are met.

Each MIH teammate who participates in patient care will be held to these expectations
below mentioned requirements and must be completed prior to September 30 of the current
year. Failure to adhere to the required training mandated by the Medical Director may be
subject to disciplinary action and/or removal from transport status.

Annual Requirements:

• Skills Competency (detailed description on subsequent pages)
o ALS Sim Lab – 1 lab per quarter for a total of 3 labs annually

o Bi-annual skills competency with assigned Preceptors
 Generally timed at 2nd and 4th quarters of the calendar year

• Required Clinical Education
o Monthly Education will be based on the competency level of NRP-P education. Topics
will meet the needs of CAMTS. required annual topics, and some will be as identified
in QA/Ql
o Airway Workshop

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 To be completed by all Paramedics via distributive educational format once
during the current educational year. Skills based airway will be completed at
the biannual skills.

o Ground Briefing Safety
o ACE Modules

 AH requirement available as advertised by AH, to be completed by Sept 30 in
alignment with annual evaluation time.

 ACE module content is loaded annually by Core Connect with review by MIH
for applicable modules meeting departmental, organizational, and regulatory
needs

o Stress Recognition & Management
o Sleep Deprivation
o Just Culture philosophy and application
o EMS Rules and Regulations
o Radio Communications

Required Certifications and Maintenance:
• All new teammates existing certifications are reviewed upon either hire or transfer to MIH.
Any deficits will be identified and acquired within the designated time frame per the
teammate’s job description.

• All Paramedics having been employed for one year or greater with MIH are required to
obtain/maintain one of the following certifications.
o NRP – National Registry
o NC EMT-=Paramedic
o SC State of Certification.
o IBSC CP-C (Certified Community Paramedic)

• Teammates who hold a single state EMS Credential will obtain/maintain National Registry
credentials and dual state credentials (EMT, AEMT, Paramedic; NC & SC).

• All ALS personnel are required to maintain a current provider status in the following
certifications:
o Basic Life Support for Healthcare Providers (BLS)
o Advanced Life Support (ACLS)
o Pediatric Life Support (PALS)
o Trauma course
 International Trauma Life Support
o CEVO (Notification and new training code will arrive within a few days).

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EMS Certifications – State and National Registry
• All teammates are required to hold SC and NC certifications to provide patient care in both
states. As SC is a National Registry state, teammates will be required to hold NR certification
as well.
• All teammates with National Registry certification will be responsible for affiliating with
MedCenter Air, inputting their recertification requirements via the online portal
(www.nremt.org) and alerting Education Team to the need for validation. Education
completion for National Registry is a 2-year cycle.
• Continuing education for NC EMS credentials is normally through your primary service. Your
service is responsible for recertifying you to the state. Education completion for NC is a 4-
year cycle.
o Reference NC OEMS continuing education guidelines.

North Carolina Office of EMS Continuing Education Guidelines
• Continuing education for SC EMS credentials is managed by your dashboard in NREMT.org.

State recertification requires background check / fingerprinting every renewal.
• Reference iOPS360 site ->education-> resources for MIH specific tools.
• Please ensure your personal profile information on Continuum (NC/SC) annually.

o NCOEMS Personal Profile Information
o SC DHEC Personal Profile Information

Driving Certifications and Validation:
• The following driving certifications are acceptable in accordance with Mobile Integrated
Health and AH Transportation: CEVO or Experienced Driver
o Didactic portion completed on-line. No expiration date is printed on the certificate.
Mobile Integrated Health will define the expiration date as 2 years from date taken
(last day of the month). You will receive the key automatically the month of your
expiration. o Driving courses to be offered monthly at minimum.
o All providers are required to complete the driving course annually.
o Driver acknowledgement forms (MVR) will be done annually (usually with the driving
practicum).
o Failure to complete the CEVO online course prior to expiration will result in AH
Transportation removing the teammate from AH insurance; thereby, rendering the
teammate as ineligible to drive an AH vehicle.
o MVRs that indicate the teammate has more than 6 points (as defined by AIG
insurance, not DMV) against their license or have had a license suspension may
become ineligible to drive AH vehicles.

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Educational Delivery Platforms:
• Classroom
• Online
• Videoconference
• iOPS360 website - your login and password to this website are to be treated as your AH login
and password regarding security. The site access is a privilege and is a tool to facilitate
education and communication from the MIH Education Team.
• Distributive education is defined as education delivered where the educator/instructor are
not able to interact in real time.

Disciplinary Action
• Teammates who allow their license, registration, or certification for their discipline to expire
are to receive written counseling. Because the registration or certification is needed for their
job position, the teammate will be placed on unpaid leave of absence beginning the first day
following expiration. During this leave they may not work in another job position or light-
duty. If the teammate does not present their license, registration, or certification within 15
calendar days the end of employment will result. AH policy HR-1.04
• Teammates who allow certifications that are required on their job description to expire will
receive written counseling and will be placed on an unpaid leave of absence beginning the
first day following expiration. During this leave they may not work in another job position or
light-duty. If the teammate does not present their certification within 30 calendar days, the
end of employment may result. AH policy HR-1.04.

• Bi-annual skills are to be completed twice per year (during the second and fourth quarters of
the calendar year). Failure to complete these requirements will result in:
o A verbal warning and require the teammate to meet with their educator within 2
weeks of the end of the quarter to complete the skills. Failure to meet this deadline
will result in written warnings up to and including termination.
o Removal from active status until Bi-annual Skills is completed.
• Failure to complete Bi-annual Skills two consecutive times will result in the
teammate repeating of Crew Oral Boards with Medical Director oversight.
o Any teammate performing below satisfactory in any category during the Bi-Annual
Skills will be directed to the Education Team for Counseling for Improved
Performance (CFIP).
o Failure to comply with the CFIP within the designated time will result in removal
from active status until approved by Medical Director and leadership of Mobile
Integrated Health.

Licensure Verification
• The teammate will enter a “new license” via iOPS360 to alert the Education Team of
renewed license.
• The Clinical Educator will verify the license via the online site using an approved HR process.
• When the renewal notification is complete the Clinical Educator will update IOPS360 site, API,
Human Resources, the teammate’s supervisor, and the teammate.

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Service Lines

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MIH Service Lines

Care Management: Emergency department high utilizers
Carolinas Rehabilitation: Home assessments to identify safety concerns and home

accessibility prior to inpatient discharge

Covid Hotel: Temporary shelter for COVID+ patients unable to quarantine at home.
Chronic Complex Care: High risk readmission patients with chronic diseases and

complex care

Heart Success Clinic: High risk Heart Failure patients
Hospital @ Home: COVID+ patients and complex patients with Chronic Diagnoses.

Levine Cancer Institute: Cancer patients
Levine’s Children Hospital: Pediatric patients

Myers Park Pediatrics: Newborns born to COVID+ moms
Pace of Southern Piedmont: Age 55+ population,
Pediatric Trach Vent
Primary Care @ Home: High Risk Internal Medicine patients
Safe Alliance: Women’s Shelter
Sanger Heart and Vascular: Cardiology

Transition Services: Temporary Internal Medicine practice servicing patients at high risk

for hospital readmission and Emergency department high utilizers.

Covid Vaccine Imitative: Homebound patients requesting vaccination

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Patient Scheduling and Visit Types

Atrium Health’s current patient scheduling platform is EPIC. MIH utilizes the EPIC scheduling system
to schedule all its service lines. Each services line has its own scheduling template providing an
opportunity for teammates to schedule, reschedule, cancel and no-show patients’ appointments as
appropriate.

Well Check Visit: 30-minute time slot visit – Non provider visit which includes a full patient

assessment, vital signs, lab work, medication reconciliation, patient education as directed. Patient is
not provided a designated appointment time. Paramedic will attempt to contact patient while
enroute, approximately 30 minutes prior to arrival

Virtual Visit: 60-minute time slot visit, provider/ancillary guided visit, includes a 30-minute virtual

visit with a provider or ancillary staff member with the assistance of Vidyo virtual video program.
Paramedic will arrive 30 minutes prior to scheduled appointment time, complete a full patient and
environmental assessment, medication reconciliation, obtain vital signs, notifies the providers when
ready to begin visit. With the assistance of Vidyo, the Paramedic provides the ability to zoom in to
specific areas of provider concern. At the conclusion of the provider visit, the Paramedic will remain

with the patient and obtain any provider requested labs work or education.
Home Assessment Visit:

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Equipment

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Pediatric Equipment Bag

Left Outside Pocket Right Outside Pocket
2x2 Nasal bulb suction 3
Heel Warmer Yaunker suction 2
Heel Lancet Aspirator adapter tip suction 3
Push Button Lab draw needs
Alcohol Wipes Front Center Pocket
Blood Tubes Tegaderm
Ped Blood Shuttles (yellow and pink top) Start kits
Needles (18-24g)
Top Center Pocket IV arm boards
Bili POC caps Tongue Depressor
Urine Cups 2 Vaseline gauze
EKG electrodes 4 packs Dial a flo
Pulse ox adapter 5 PRN saline adapter
10cc flush
Inside Top Center Pocket Trauma shears
Spirometer 1 Kling medical wrap
Nasal Cannula 2ped size 6 AA Batteries
NRB 2 ped size Pediatric Airway Bag
Venti Mask 2 ped size Pediatric Intubation kit
Neb 2 ped size Pediatric go bag
Cobane 2 Suction with battery
Have 10 of each item unless otherwise
Inside Back Center specified
Copy of protocol 1
Broselow tape 1
Thermometer cover 2 boxes
AED pads - 2
Hot/Cold packs

Inside Center Pocket

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BVM (child/infant/neonate) 1 each
Thermometer 1
Thermometer Probe (blue/red) 1 each
NPA/OPA 1 kit
Stethoscope 1 double bell
Blood Pressure cuffs 1 each size

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Pharmacology Formulary/ Vehicle Medication
Bag

Medication Dose

Acetaminophen 500mg
Albuterol 2.5mg/3ml
Albuterol MDI
Amoxicillin 500mg
Aspirin 81mg
Augmentin 875mg
Azithromycin 500mg
Calcium Carbonate 500mg
Clindamycin 300mg
Clonidine 0.1mg
COVID Swab
D10 250ml
Dexamethasone 2mg
Diltiazem 30mg
Diphenhydramine 25mg
Doxycycline 100mg
DuoNeb 0.5/3ml
EPI 1:1000 1mg/ml
Flagyl (metronidazole) 250mg
Flagyl (metronidazole) 500mg
Furosemide 40mg
Heparin Flush 500 units
Ibuprofen 200mg
Insulin Syringes
IV Ceftriaxone (Rocephin) 1mg
IV Amiodarone 150 mg/3ml
IV Calcium Gluconate 1000mg/10ml
IV Decadron 4mg/ml
IV Diltiazem 50mg/10ml
IV Diphenhydramine 50mg/10ml
IV Flaygl (metronidazole) 500mg
IV Flaygl (metronidazole) 500mg 100ml
IV Furosemide 100mg/10ml
IV Glucagon 1mg
IV Humulin R 100 units/ml
IV Labetalol 100mg/20ml

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IV Ondansetron 4mg/2ml
IV Phenergan 25mg/1ml
IV Toradol 30mg/ml
Keflex 500mg
Levaquin 500mg
Levaquin 750mg
Lidocaine 1% 200/20ml
Lovenox 40mg
Magnesium Oxide 400mg
Magnesium Sulfate 1mg/2ml
Metoprolol 25mg
Metoprolol 5mg/5ml
Naloxone 2mh/2ml
Nitro Paste
Nitro Sub 20mg
Omeprazole 4mg
Ondansetron 37.5mg
Oral Glucose 25mg
Phenergan 20 mg
Potassium Chloride 20mg
Prednisone 1 mg
Sodium Bicarbonate 40mg
Solumedrol 125mg
Solumedrol 10ml
Sterile water for injection 10cc
Syringe 3cc
Syringe 1.25/3ml
Xopenex (Levalbuterol)

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Paramedic Daily Workflow

MIH currently staffs 3 shifts:
0700-1900
0900-2100
1100-2300

1. Arrive by 0700- Arrive at warehouse and retrieve daily call sheet/truck
assignment.

2. Check out supplies/virtual equipment
 Validate all necessary supplies are included
 Perform standard truck check off
 Drive over to office for patient assignment a

3. Arrive by 0745 at MIH Office
 Retrieve daily Microsoft Teams Excel patient list in CP Teams page.
 Review sheet for any safety concerns

4. Using assignment list as a guide, log into EPIC
 Review and confirm patient address and phone number. Noting any
temp addresses indicated.

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 Review patient appt desk to confirm appointment time, provider if a
virtual visit.

 Review appt notes to review any request or needs such as labs, or
specific needs.

5. Log into Canopy for research
 Review the following: Patient discharge and progress notes (from
Hospital and/or CP/ HAH Provider encounters) • Vitals (for baseline)
Patient history and previous care from day before (may indicate additional
system assessments needed) • Changes in care

• Review Medications/ Changes
• Identify patient needs

6. Plan Daily Driving Route- Prioritizing patients by acuity and need.

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Fleet Services

Mobile Medicine Fleet is the behind-the-scenes logistics center for Mobile Medicine.
Fleet services assist with documentation and tracking of essential automotive and supply
items. MMFleet provides an outside-the-department perspective that does not form internal
relationships within departments allowing for a non-biased view of cost and activities. This is
important when tracking vehicle inspection compliance as set by governing bodies such as
CAMTs and DOT.

To monitor compliance of the 22 MIH units fleet uses a product called GEOTab. It is a
cellular-driven product that allows for GPS and data uploads of vehicle information every
second there is cellular service. The GEOTab devices track location, driver habits, speed and
interact with a camera system (ROSCO Cameras) that captures real-time video if issues are
detected. This has been beneficial with accident investigation and investigation of
complaints about drivers or vehicles.

Currently, AH MIH has 22 units. These units are different manufacturers due to
availability. We have 2022 Ford Explorer XLT’s on order with expected delivery in
September. These units were procured through a corporate lease agreement with
Enterprise and will be registered to the system for compliance, speed pass, and insurance
purposes. The new units will replace older units and will standardize the fleet. Explorers
were chosen due to the availability of parts and components we add to the vehicle before
placing it in service.

Lastly, MMFleet orders, stocks, and maintains all supplies and equipment for the
MIH program. We use a product called IOPs360 for checklists and equipment accountability.
Every piece of assigned equipment must be scanned into a checklist to remain compliant. At
the end of every day, an MMFleet member rescans all returned equipment to ensure there is
no lost, or damaged equipment during that shift. This has proven very beneficial to show

utilization of equipment and assist in tracking down when damaged or loss
occurs. For supplies, there are assigned BINs with supplies in them. The MMFleet

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team restocks the BINs daily to meet minimum quantities as established by the program and
documented on a checklist. This process has multiple checks and balances and ensures that
every teammate goes out the door with the correct supplies and equipment to be mission
ready.

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MIH Proforma

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Billing Systems

Golden Hour Information Services: Leader in Emergency Medical Transport Billing and
Reimbursement. Golden Hours supports a national footprint of long-time client partnerships
with recognized Air and Ground EMS programs with proven services and technologies and
currently supports over 80% of the air medical transportation industry and 20% of the ground
EMS transport market.
Interdepartmental Billing: Process used to direct bill internal departments for services and
supplies provided to departments within Atrium Health.
Service Line Agreements: an agreed upon document between MIH and non -Atrium
departments/facilities defining aspects of coordination of care, services rendered and
payment expectations.

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Communication

Oracom OMCAS (Manager) A custom CAD system application for hospital-based
services to aid in the productivity of external and internal communications. Manager is
used to transfer data and communication in real-time, working to improve internal and
external communication, reduce redundant data entry and manage other aspects for
such as QA, Process Improvement and Fleet Maintenance. Add link

Iops360: A fully featured EMS Emergency Medical Services Software that offers billable
items, tracking, shift and supply management just to name a few of its capabilities. MIH
currently uses Iops360 for: Equipment tracking, truck check offs, supervisor logs,
education overview, training, quizzes, certification, skill tracking, employee documents,
inventory and work orders. Add link

Halo Platform: A unified HIPPA compliant communication and on-call scheduling
platform for acute, ambulatory, and long-term care providers.
Halo is used in MIH-CP as a secure messaging clinical platform to communicate
sensitive patient health information.

Status Video Interpreter Services: 24 hours on demand HIPPA compliant medically
certified face to-face video language interpretation of over 40 languages including
American Sign Language (ASL) and Certified Deaf Interpretation (CDI) Add Link

Dispatch

Atrium Health’s MIH program utilizes already existing infrastructures when it comes to
dispatching.
Our Flight watch Infrastructure hires and specifically trains dispatchers on how to dispatch
for MIH safely and efficiently.
We currently utilize 800mhz handheld radios when in the field.

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When enroute to a call we check enroute with dispatch, “CP 1 enroute to address.....”
Dispatchers confirm via radio and check “enroute” in Manager for that patient.
Once CP arrives on scene of residence, CP checks “on scene” with dispatch.
Dispatch automatically sets a timer for 15 minutes and does a safety check with the
paramedic on scene to ensure they are safe and then CP responds with amount of time
needed before next safety check.
Our dispatchers also enter the calls for the next day using Epic schedule allowing our CP-
Lead for the day to prepare

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Atrium Health Mobile Integrated Health Recognition

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