(PROVIDENCE) – In late 2019, Heather had been in tremendous pain for about a week before she finally called 911.
“My stomach was burning, and it was painful and I just remember calling them and telling them, ‘I don’t know what’s going on’,” she recalls.
She expected an ambulance to show up at her Providence home, so she was surprised when, instead, she saw a brand-new City of Providence Fire Department SUV pull up.
Heather found herself receiving emergency care as part of the Mobile Health Initiative, a collaboration among the City of Providence, the Providence Fire Department, Providence Community Health Centers, and Neighborhood Health Plan of Rhode Island.
“The Mobile Health Initiative is designed to combat the basic life support runs . . . and get people who call for what seem to be non-emergencies to the Providence Community Health Centers’ Express Clinic rather than tying up the emergency room,” explains Zachariah Kenyon, Providence Fire Department’s Chief of Emergency Medical Services.
The initiative also helps connect patients to primary care doctors “so then they can eventually start using a primary care physician, instead of calling 911 [for non-emergencies],” Chief Kenyon says.
When Heather called 911 that day, the dispatcher who took her call assessed her need as non-emergent; she was precisely the type of patient who needed to be seen by a doctor, but who didn’t have to be rushed to the emergency room.
From her perspective, Heather’s experience was “amazing”.
“The lady and the man who picked me up explained the whole thing as they were assessing me,” she says. “And I’m thinking, maybe it would be better if I’m not sitting there for hours at the hospital.”
“They came quick, they were courteous,” Heather adds. “They made sure that I was comfortable, they asked me every single question that they could ask me from picking me up to taking me [to Providence Community Health Centers’ Prairie Avenue Express Clinic] and explaining the whole process.”
Heather was seen quickly, treated for acid reflux, and was headed home before she knew it.
Merrill Thomas, president and CEO of Providence Community Health Centers, believes the initiative helps his organization achieve its goals of being “efficient and more cost-effective”.
“For our patients, why wait six hours in the emergency room for something you don’t need to go there for,” Thomas asks. “We’ve always been trying to divert people from that costly setting to something more efficient and effective. And [we are] trying to change patterns [so] people just don’t think of the emergency room first; they think of our Express Clinic instead.”
Thomas says the idea for the Mobile Health Initiative was born when Providence Community Health Centers “were working with the fire department on trying to reduce the number of calls. So, with our Express Clinic this came up in the joint discussion with them and sort of lead to this.”
As the discussion evolved, Neighborhood Health Plan of Rhode Island was an eager partner.
“Chief Kenyon said, ‘Look, one challenge we have is actually getting our hands on a vehicle,’” says Neighborhood President and CEO Peter Marino. “So, we said, ‘We’ll take care of that’. [Neighborhood] bought the vehicle. [Providence Fire] got it ready and prepped and they found two fantastic staff folks to do the work.”
It’s a creative partnership that, according to Marino, represents “a new way of thinking about this healthcare system.”
According to Marino, the Mobile Health Initiative complements Neighborhood’s overall belief that “we’ve got to do something different, and we have got to come up with a way to better serve our members and save money at the same time. And this really hit the mark.”
Neighborhood’s Chief Medical Officer Dr. Marylou Buyse calls the initiative a “terrific idea [and] a different way to make sure that people get the care they need where they should get it and not just going to the emergency room.”
“We have a problem here in Rhode Island which is about emergency room overcrowding,” Dr. Buyse explains. “Yet there are low acuity health problems like a sore throat or runny nose or a cold or the flu that could be easily taken care of . . .here at Providence Community Health Centers. [The Mobile Health Initiative] promotes continuity of care because if you go to the emergency room, chances are they don’t know you and you’re being treated in isolation from the rest of your health history. So, if you’re treated [at Providence Community Health Centers], if you’ve been a patient here, you will have tremendous continuity of care and get some needed follow-up.”
“I think we all know that health care is not functioning the way that it should function to be maximally efficient and also maximally helping patients,” says Dr. Katherine Williams, medical director of the Express Clinic at Providence Community Health Centers.
“Having people go to the emergency room, waiting hours and possibly getting more illnesses while they’re in the waiting room is not in their best interest. So this something that we’re constantly thinking about: How can we fix the system? How can we improve on it? And this program really has been great in terms of at least tackling one component of the system.”
Early results are promising. The Mobile Health Initiative began in August of 2019, and as of early February, Chief Kenyon says the program has had contact with 420 patients.
“We’ve diverted 102 of those patients either to Providence Community Health Centers or BH Link – a behavioral health facility in East Providence,” Kenyon explains. “If you think of the 102 people who have already possibly gotten primary care, and who are no longer using the 911 system for non-emergencies – and the amount of dollars saved from that person going to an Express Clinic versus an emergency room – I think we’re on the right path.”
Neighborhood’s Marino is optimistic about the initiative’s future, based largely on the commitment of the collaborators.
“Neighborhood Health Plan’s bedrock is working with great partners throughout the state,” Marino says, “and we’re fortunate in this particular initiative [to have] the City of Providence with Mayor [Jorge] Elorza and Chief Kenyon – bringing an idea like this forward and working with the Providence Community Health Centers, which has probably some of the best leadership in the state.”
Marino concludes: “Bringing our resources together and working together to come up with a solution that delivers great care to our members, and does it at a cost that taxpayers can afford, really drives home the fact that having partnerships is what it’s all about.”