An interventional study of Mobile Integrated Healthcare/Community Paramedicine (MIH/CP) Support in Hospital Readmission, Pneumonia and Myocardial Infarction, sponsored by Rhode Island Hospital. Status unknown. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2022-06-01.
Sponsored by Rhode Island Hospital · Not applicable, Interventional, and Health services research
Background:
Initially conceived of as a method to address healthcare needs of underserved rural populations, Mobile Integrated Healthcare and Community Paramedicine (MIH/CP) is a new model of inter-professional, community-based outpatient healthcare delivery that primarily utilizes the resources and training of Emergency Medical Services (EMS) to fill gaps in local healthcare infrastructure, expanding existing scope of practice in most cases while not detracting from acute transport capabilities.
Although programs have been in existence since the early 1990s, there are few objective studies of the efficacy, safety, and cost-effectiveness of MIH/CP programs, many of which are limited-scope pilot projects. The limited data already published on these measures by established programs shows substantial Medicare charge-avoidances in patients enrolled in CHF-readmission prevention and EMS frequent user programs, and a significant reduction in Emergency Department visits overall, especially in austere environments.
In summary, MIH/CP is an attempt at formalization of long-standing practices to collaborate with and supplement other healthcare system components such as primary care and home health services. Standardized, objective data collection and publication of results will be needed to support continuation and financial support of this emerging concept.
Objective/Hypothesis:
Using the existing resources of the MD-, RN- and Paramedic-staffed Lifespan Pediatric and Adult Critical Care Transport (LifePACT) service, investigators aim to study whether implementation of an MIH/CP pilot program tailored to the needs of an urban, underserved population in Providence, Rhode Island, will reduce the rate of 30-day hospital readmissions for patients after discharges for community-acquired pneumonia, acute MI, and COPD. In addition, investigators will study whether such a program is considered to be safe (in terms of not increasing the number of adverse events post-discharge for patients or compromising the efficacy of the LifePACT transport role) and considered satisfactory by patients (rated comparably to visits by other outpatient health care services such as VNA services).
2,072 studies on the registry are indexed under Pneumonia; 286 are open to participants now.
This study's enrollment of 44 is below the median of 107 across 1,263 interventional studies indexed under Pneumonia.
Browse Pneumonia studies →Rhode Island Hospital is the lead sponsor of 191 studies on the registry; 37 are open to participants now.
Of its 11 completed or terminated interventional studies of FDA-regulated products, 2 (18%) have results posted.
Counted across the registry records on this site, refreshed daily.
Inclusion Criteria:
Participants receive standard of care.
Initial Home Visit: MIH/CP provider team will visit the patient's home at the scheduled time following a specific General Followup Protocol involving 1. Assessment of patient understanding of recent illness and medical therapy including reinforcement of medical adherence, 2. Any other disease-specific concerns, 3. Performance of a home safety evaluation, 4. If patients have concerns relating to their ability to manage their disease process at home, 5. MIH/CP providers and an on-call social worker will provide assistance in the form of on-site, telephone, and electronic referrals or provision of appointments with appropriate services. Subsequent visits: The MIH/CP team will decide in conjunction with Medical Control and the PMD if further followup is needed, and the most appropriate followup interval., At 30 days from initial hospital discharge, the patient will be discharged from the MIH/CP program in conjunction with the PMD.
Other: Mobile Integrated Healthcare/Community Paramedicine (MIH/CP) Support
MIH/CP provider and their team will offer additional support and connection to resources after patient is discharged from hospital.
Incidence of hospital readmissions
Time frame: 30 days
Incidence of adverse medical events
Time frame: 30 days
Incidence of ED visits
Time frame: 30 days
No study locations are listed for this record.
Plan to share: Undecided
No publications or documents are linked to this record.
Ran from Feb 2016 to primary completion in Oct 2020, 56 months.
Of 293 non-industry interventional studies with no phase under Pneumonia, half reached primary completion within 21 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 36. This study's 56 months is above that.
Counting every sponsor, half of 303 studies reached it within 21 months; a quarter within 10 and three quarters within 36.
How these figures are worked out, and which studies are left out of them.
This study is status unknown, as verified in Sep 2021. You cannot join it, but the record below documents what was studied.
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