Mobile Integrated Healthcare Partnerships Reduce the Impacts of Substance Use

The MIH team distributing goods to a resident. (Photo courtesy of West Allis Fire Department)

In the face of the ongoing opioid epidemic, the West Allis Fire Department (WAFD), in partnership with the Medical College of Wisconsin (MCW) and the Milwaukee County Office of Emergency Management (OEM), has taken bold steps to combat the devastating effects of substance use. Recognizing the urgent need for action, WAFD has implemented a Mobile Integrated Healthcare (MIH) program, which has proven instrumental in reducing overdose incidents and deaths. This innovative approach has garnered widespread acclaim and has won an award in recognition of its outstanding achievements.

The 24/7 MIH team has revolutionized patient care by providing personalized assistance directly to individuals in their homes or preferred environments. By offering in-person support, the team connects patients with crucial services such as medication-assisted treatment, harm-reduction materials and wrap-around care. This comprehensive approach has demonstrated remarkable success in reducing instances of overdose and overdose-related deaths. Notably, the collaboration between WAFD, MCW and OEM, along with their associated healthcare partners, sets a new standard for coordinated referral and wrap-around treatment between an MIH team and an emergency department.

From 2021 through 2022, the MIH team received 483 patient referrals, of which 357 (74%) were visited. Impressively, 164 individuals (34% overall; 46% of those contacted) were enrolled in medication-assisted treatment (MAT), highlighting the program’s effectiveness in connecting those in need with essential care. Additionally, the team distributed over 1,300 harm reduction kits and educated more than 2,000 people on the available resources for individuals struggling with substance use.

“The West Allis Fire Department, Medical College of Wisconsin and Milwaukee County EMS have had a collaborative relationship as an integrated EMS System for 50 years. Never has that relationship been stronger and never has the work been more novel, nor the impact on the community more profound given the challenges we face today,” said Dan Pojar, EMS Division Director at the Milwaukee County Office of Emergency Management.

The impact of the SUD (Substance Use Disorder) program spearheaded by WAFD has been felt throughout all segments of the community. In West Allis, between 2018 and 2022, the overdose incident rate decreased by 24% (40 incidents), and the death rate was reduced by 9% (4 deaths). These numbers stand in stark contrast to the surrounding Milwaukee County, which witnessed a distressing 36% increase in overdose incidents (1,805 incidents) and a staggering 62% rise in overdose deaths (260 deaths) during the same period.

As part of the success behind this initiative, the department credited its use of ImageTrend technology. ImageTrend solutions enabled the MIH team to analyze data, identify trends and make critical conclusions about the opioid crisis. Notably, the data uncovered that a significant number of overdose incidents and deaths in West Allis were among individuals from underserved neighboring municipalities, leading to the expansion of services to address the needs of the greater Milwaukee County area.

Moreover, ImageTrend solutions facilitated geographic diagnostics, empowering the MIH team to focus on specific regions and populations most in need of assistance, irrespective of municipal borders. This innovative use of data-driven decision-making not only tailored service delivery to citizens’ needs but also supported the optimization of municipal budgets and resources.

In a groundbreaking move, the MIH team expanded services by introducing and initiating medication for the treatment of opioid use disorder. Specifically, paramedics began utilizing buprenorphine to alleviate opioid withdrawal symptoms, thereby increasing patient engagement with treatment. To enable this novel treatment delivery model, the MIH team collaborated with local, county and state partners to expand the paramedic scope of practice statewide.

“The addition of buprenorphine to the Wisconsin EMS Scope of Practice was intended to provide EMS agencies with additional resources to mitigate the devastating impact of Substance Abuse Disorder in our communities. The West Allis Fire Department’s MIH team was the first EMS agency in the state approved to utilize buprenorphine,” said M. Riccardo Colella, DO, MPH, Wisconsin State EMS and Trauma Systems Medical Director and Professor of Emergency and EMS Medicine at the Medical College of Wisconsin.

The ImageTrend features were instrumental in identifying suitable patients, collecting comprehensive data and ensuring seamless follow-up, allowing for the transferability of lessons learned to other EMS sites interested in adopting similar practices. The next phase of their efforts will leverage ImageTrend Telehealth™ to facilitate physician consults and bridge prescribing for individuals struggling with substance use, further advancing their impact.

“Breaking down barriers between patients and the care they need is critical to enhancing health in our community. Tools such as field-based buprenorphine and telemedicine allow for not only improved patient care, but ultimately better patient outcomes and a healthier community,” said Ben Weston, MD, MPH, EMS Medical Director for Milwaukee County and Associate Professor at the Medical College of Wisconsin.

The close-knit partnerships between WAFD, MCW, OEM and their collaborators have paved the way for sustained collaboration in addressing substance use disorder in Milwaukee. Together, they continue to explore innovative ways to utilize the suite of ImageTrend software, enhancing data collection, utilization and dissemination. This ongoing commitment ensures that this unique patient population receives the critical care and support they need.

The tireless efforts of the WAFD, MCW, OEM and their partners in implementing the MIH program have yielded remarkable results in combating the devastating impacts of substance use. By prioritizing community-centered care, leveraging advanced technology, and fostering collaborative relationships, they have set a commendable example for other healthcare organizations nationwide. The nomination of this program for an award rightly recognizes its outstanding achievements and serves as a testament to the power of mobile integrated healthcare partnerships in reducing the impacts of substance use.

WAFD and MCW were recipients of a 2023 ImageTrend Hooley Award in the New Frontier category. The Hooley Awards recognize innovators and thought leaders, honoring their involvement, creativity, and passion, and were founded to acknowledge their contributions to innovation and excellence. The Hooley Award finalists were celebrated, and the winners were announced during the 15th annual ImageTrend Connect Conference.