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Public health at the front door: An MIH model to emulate

Prisma Health’s community paramedics are leading with compassion and evidence, tackling addiction, rural care gaps and chronic conditions in real time

In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation’s most forward-thinking mobile integrated healthcare programs. Prisma Health’s team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically.

| MORE: How North Dakota EMS is confronting rising pediatric mental health crises

Whether it’s addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing.

Rob is joined by four key voices from the Prisma Health MIH program:

  • Luke Estes, director of MIH
  • Dr. Mirinda Gormley, epidemiologist and biostatistician
  • Wes Wampler, community paramedic specializing in addiction and infectious disease
  • Parker Bailes, community paramedic and research contributor

Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn’t just novel — it’s necessary. This is EMS in its truest public health form.

Memorable quotes

  • “You delivered the goods—data-driven, community-connected care — and that’s what EMS in 2025 needs more of.” — Rob Lawrence
  • “When you see some of your people who have a passion for a certain pathway in EMS, you try to give them the reins and say, you’re gonna do some good.” Luke Estes
  • “One of the big things that we learned from his study was that we really needed to go out and make sure everybody was aware that addiction is a disease.” Mirinda Gormley
  • “If we can gain their trust, there’s a lot more that we can kind of weasel our way into to help them solve and get them on a healthier trajectory.” Wes Wampler
  • “Walking into the (care) facility with the mindset of, ‘I’m going to do everything I can to keep you here,’ was a big shift for me.” Parker Bailes
  • “If we can set them up to be successful after they leave the hospital, I think that’s the best way to get them reengaged with the hospital.” Wes Wampler
  • “As their leader … all I have to say is, what do you need? I’m here to support you.” Luke Estes

Additional resources

Episode timeline

00:51 – Introduction to Prisma Health MIH & guests
03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction)
05:00 – Dr. Gormley’s public health journey, data-opioid focus
08:00 – Buprenorphine pilot design and research outcomes
10:15 – Challenges: bias, stigma, barriers to addiction care
13:00 – Funding and sustainability conversation
14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care
17:00 – Building trust with vulnerable populations
18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions
21:45 – Alternative destinations, lab draws and high-acuity decisions
25:30 – Training: internal education, ultrasound, medication management
28:15 – Prisma’s med school connection and disaster response evolution
30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams
31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals
35:26 – Final reflections from Luke Estes: passion, team strength and mission
38:00 – Rob’s call to action: “If you want your own Prisma team — start now.”

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Previously on EMS One-Stop
This EMS One-Stop international edition features Steinar Olsen, director for EMS and national preparedness in the Norwegian Directorate of Health

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is the President of the Academy of International Mobile Healthcare Integration (AIMHI) and former Board Member of the American Ambulance Association. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.