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The 10 peer-reviewed articles on MIH-CP you need to read right now

Interested in learning more about the scope and growth of mobile integrated health and community paramedicine? Start right here

Regardless of the origins of the terminology, the growth in MIH-CP literature over the past few years has been substantial.


Kevin McGinnis is often credited with coining the term “community paramedics” in a 2001 Rural Health News article. Since then, the debate around the terminology of community paramedicine versus mobile integrated healthcare remained relatively heated until a number of national organizations, including NAEMT and NAEMSP, released a joint vision statement defining the larger concept.

Regardless of the origins of the terminology, the growth in MIH-CP literature over the past few years has been substantial. For someone new to this part of the EMS industry, it could even be considered overwhelming. As community paramedicine and mobile integrated health programs become more common, research into their scope and practice will continue to grow.

Interested in learning more about MIH-CP from a research-based perspective? Start by reading these 10 peer-reviewed articles:

1. Expanding paramedic scope of practice

Expanding paramedic scope of practice in the community: a systematic review of the literature
Bigham BL, Kennedy SM, Drennan I, Morrison LJ
“Prehospital Emergency Care”

This was the first major review of the MIH-CP literature. By summarizing the 11 articles that did exist from across the world, this review demonstrated just how little peer-reviewed research there was at the time on MIH-CP.

2. Expanding paramedicine in the community

Expanding paramedicine in the community (EPIC): Study protocol for a randomized controlled trial
Drennan IR, Dainty Katie N, Hoogeveen Paul, Atzema CL, Barrette N, Hawker G, Hoch JS, Isaranuwatchai W, Philpott J, Spearen C, Tavares W, Turner L, Farrell M, Filosa T, Kane J, Kiss A, Morrison LJ

As with most other things in medicine, MIH-CP is currently relying on early adopters with favorable outcomes to demonstrate benefit. The EPIC study aims to provide proof that MIH-CP is a viable healthcare alternative for certain patients through a randomized control trial.

This article includes the study protocol and explains some of the background literature as well as the individual study arms for the trial. The randomized controlled trial is still ongoing, so full results are not available, but a positive case study has been published.

3. MIH and CP: An emerging emergency medical services concept

Mobile integrated health care and community paramedicine: An emerging emergency medical services concept
Choi BY, Blumberg C, Williams K
“Annals of Emergency Medicine”

This article is one of the best summaries of MIH-CP that exists. It’s targeted toward emergency physicians, so it assumes some baseline knowledge of EMS. Overall, it’s well written and covers many of the important points in a systematic way. It provides a great starting point for administrators that want something more than a one-page summary on mobile integrated health-community paramedicine.

4. Telehealth-enabled emergency medical services program

Telehealth-enabled emergency medical services program reduces ambulance transport to urban emergency departments
Langabeer JR, Gonzalez M, Alqusairi D, Champagne-Langabeer T, Jackson A, Mikhail J, Persse D
“Western Journal of Emergency Medicine”

The Houston Fire Department’s ETHAN program uses telehealth within its dispatch system to triage low-acuity patients out of the normal 9-1-1 response protocols. This study demonstrated that overall, the program is effective at decreasing unnecessary ambulance transports as well as accelerating how quickly paramedics go back into service.

5. Providing acute care at home

Providing acute care at home: Community paramedics enhance an advanced illness management program-preliminary data
Abrashkin KA, Washko J, Zhang J, Poku A, Kim H, Smith KL
“Journal of the American Geriatrics Society”

This study was performed by the team at Northwell Health. In it, they demonstrated how a hospital-based MIH-CP program could have an impact on overall transports, as well as patient acuity when transport was required.

6. Evaluation of California’s community paramedicine pilot program

Evaluation of California’s community paramedicine pilot program
Coffman JM, Wides C, Niedzwiecki M, Geyn I
UCSF Healthforce Center

The Healthforce Center at UCSF was tasked with evaluating the 13 MIH-CP programs across California. The final document provides an excellent summary of the six different MIH-CP models being piloted while systematically measuring the success of each model across various metrics.

7. Community paramedicine applied in a rural community

Community paramedicine applied in a rural community
Bennett KJ, Yuen MW, Merrell MA
“The Journal of Rural Health”

Most of the recent attention on MIH-CP has focused on the success (or failures) of programs in large organizations that reside in urban centers. This study, based in Abbeville County, SC, demonstrated a decrease in emergency department and inpatient visits for those enrolled. As with most other MIH-CP evaluations, it’s not a large group of patients, but it does show success is possible away from a major city.

8. Community paramedicine pilot programs lessons

Community paramedicine pilot programs: Lessons from Maine
Pearson KB, Shaler G
“Journal of Health and Human Services Administration”

This article is similar to the California evaluation, only it provides data and analysis on the 12 programs throughout the state of Maine. It clearly details how some of the economic calculations were made, in a way that many prior publications left out.

9. State regulation of community paramedicine programs

State regulation of community paramedicine programs: A national analysis
Glenn M, Zoph O, Weidenaar K, Barraza L, Greco W, Jenkins K, Paode P, Fisher J
“Prehospital Emergency Care”

One of the greatest barriers any non-traditional EMS program faces is how to be reimbursed without transporting a patient. Advocates for MIH-CP have long recognized this critical issue, and focused their efforts on state laws that define how care can be provided and reimbursed in the prehospital setting.

This scope of practice review was the first of its kind to summarize state laws as they apply to MIH-CP programs. Its timing was fortuitous given the momentum state-level MIHCP advocates have been gaining over the last five years.

10. NAEMT’s MIH-CP Knowledge Center

MIH-CP Knowledge Center

While this is not technically a peer-reviewed journal article, NAEMT has done an amazing job of keeping tracking of each mention of MIH-CP within the popular press, peer reviewed journals, and everything in between.

The site is maintained by the same team that rolled out the first-ever survey of MIH-CP programs in 2014 and is currently rolling out its second iteration. It’s safe to assume that this knowledge center will continue to be an extremely valuable resource for those within community paramedicine as the industry continues to evolve.

Catherine R. Counts, PHD, MHA, is a health services researcher with Seattle Medic One in the Division of Emergency Medicine at the University of Washington School of Medicine. She received both her PhD and MHA from Tulane University School of Public Health and Tropical Medicine.

Dr. Counts has research interests in domestic healthcare policy, quality, patient safety, organizational theory and culture, and pre-hospital emergency medicine. She is a member of the National Association of EMS Physicians and AcademyHealth. In her free time she trains Bruno, her USAR canine.

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