Memphis Fire MIH Program Reduces Number of Frequent 9-1-1 Utilizers

A Memphis woman called 9-1-1 early Wednesday morning and said she needed an ambulance.

She didn’t.

The woman has chronic physical and mental health problems. She lives in a troublesome neighborhood. She often needs help, but she didn’t need Emergency Medical Services. It was at least the 40th time she has called 9-1-1 in the past year. Fortunately, it was the first time in more than a week.

“It’s not perfect, but it’s progress,” said Lt. Kevin Spratlin, coordinator of Memphis Fire Department’s Healthcare Navigator Program. “We are slowly but surely getting her the real help she needs.”

Spratlin and the two paramedic/navigators on his team have spent the past few weeks connecting the woman to medical care and transportation that doesn’t require highly trained paramedics and a high-speed ambulance. The woman, who has been charged with 9-1-1 misuse 13 times since 2008, was referred to the program by the county’s new mental health court. She is a member of what local EMS calls the High Utilization Group, or HUG for short. These are people who have called 9-1-1 three or more times in a week.

“Sometimes, that’s really all they need, just a hug,” said paramedic/navigator Demetria Davis. Paramedic Tim Davis (no relation) is the other paramedic.

When the Navigators program began last year, EMS was dealing with as many as a dozen HUG members. Now they are dealing with one or two a week.

The Memphis Fire Department can’t save us all, but that doesn’t stop them from trying. The department’s EMS responds to 120,000 calls a year. That’s 3,676 calls per ambulance, or about 10 calls per ambulance per day. One in five calls is a nonemergency – meaning the person who called doesn’t require emergency medical treatment.

People call when they need a ride to the hospital or pharmacy to get medicine. People call when they are sick or in pain and don’t have a primary care physician, or can’t afford one. People call because they are disoriented or afraid or mentally disabled or just plain lonely. And, yes, people call because they’ve fallen and they can’t get up.

Response time matters, so EMS units rarely know what they’re dealing with before they arrive.

“One time, a person called 9-1-1 because they couldn’t find the TV remote,” Spratlin said. “We can be smarter about this.”

That’s the idea behind the Healthcare Navigators pilot program. It’s also the idea behind IBM’s Smarter Cities Challenge, an effort to use technology to improve city services and reduce costs.

Earlier this year, IBM sent a team of experts here to review and recommend ways to improve the city’s 50-year-old EMS department. The misuse and overuse of EMS is costing the city an extra $20 million a year, not to mention putting lives in jeopardy.

The Memphis EMS, recently named one of the best in the country, responds to each and every call for help. It’s their job. It’s what they do. But it often means that every ambulance is in service. That can more than double response time to real life-or-death emergencies.

It’s not just a Memphis problem. Cities around the world are dealing with growing and aging populations and shrinking resources.

“EMS is emerging as the primary care safety net for the uninsured and underinsured,” an IBM team said in its Memphis report. “All the while, EMS departments are being asked to provide more complex and time-sensitive services to those in dire need.

“Responding to every call for help without differentiation or regard for the impact on the well-being of the community at large puts lives at risk.”

Mayor Jim Strickland and Fire Director Gina Sweat are studying IBM’s recommendations, which include enhancing the MFD’s Navigator program.

Spratlin and others believe a larger “community paramedics“ program could save the city a lot of money. It also could drastically reduce the number of nonemergency calls by “frequent fliers,” the 2,000 or so people who call 9-1-1 more than three times in six months.

The Memphis Fire Department can’t save us all, and they shouldn’t have to try.

 

Contact columnist David Waters at waters@commercialappeal.com

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