Many of our other EMS 10 Innovation Award Winners are those who battled COVID on the East Coast. The fight took place across our nation, including our brothers and sisters on the West Coast as well.
Kevin Mackey, MD, FAEMS, is an emergency physician in Sacramento, California, and is a medical director for several EMS agencies. His roots are in EMS. Mackey became a paramedic in 1990 prior to attending medical school. He then completed his residency at the University of Pittsburgh.
In 2009, Mackey became the Sacramento Fire Service Medical Director. The currently existing Mobile Integrated Health Program was born at the Sacramento Metropolitan Fire District. This program was in the planning phases for a few years prior to COVID-19. The pandemic served as the catalyst to move the program from a planning phase to an operational phase. The program is focused on providing health surveillance, screening and prehospital evaluation. Provision of this is often centered at adult living facilities — and sometimes in private residences as well. Mobile integrated health vehicles are staffed by physician assistants, nurse practitioners and third-year emergency medicine residents working in conjunction with EMS providers.
The five fire agencies and hospitals in the Sacramento-area mobilized volunteers in a week to staff four special assignment community care response units. This came at the request of the Sacramento County Department of Public Health who had a need and reached out to the fire agencies in the area and the region’s hospital council to provide the necessary resources. Deputized by the Sacramento County Department of Public Health as critically needed medical caregivers under a special emergency disaster declaration that affords the new program with legal exemption for the staff’s medical activities, the four community care response units were staffed by firefighter-paramedics, physicians, nurse practitioners and physician assistants who volunteered their time to the program. The fire agencies involved include: Sacramento Metropolitan (Metro) Fire District, Sacramento City Fire Department, Folsom Fire Department and the Cosumnes Fire Department. These five fire agencies and the Sacramento Regional Fire Emergency Communications Center serve 1.6 million citizens with over 220,000 calls for service annually.
When the vaccine became available, another arm of the mobile integrated health program was developed. Vaccine delivery was added. Extra teams, in addition to the mobile integrated health teams were developed to do vaccinations. This program started as vaccinating their own providers, and then grew to work with drive-through and walk-through vaccination clinics. When home-bound vaccinations programs started, the MIH teams started doing in-home PCR testing for those who were awaiting surgery and needed testing prior to. This initiative was helped with a partnership with the local public health lab which provided fast testing results.
While Mackey is a driving force behind these programs and initiatives, he is a modest person and gives a wealth of credit to the folks who are out there doing the work. He credits the dedicated providers with making his job as medical director easy and a pleasure. It is Dr. Mackey’s hope that this model will improve the care of all patients in the greater Sacramento area.