Mobile integrated healthcare/Community paramedicine

The concept of MIH/CP has existed for quite some time, but more prevalent in other countries around the world than in the U.S. The primary purpose of MIH/CP programs is to provide more healthcare services directly to patients on location and to minimize unwarranted trips to the hospitals and to reduce persistent re-admissions for the same conditions.


Healthcare purveyors in Canada, Australia, and New Zealand have used the same model successfully for a number of years. U.S efforts initiated, due in large part to the Affordable Care Act, have been initiated and spreading across the country for approximately 6 years.

In 2014 the Technical Committee on Emergency Medical Services a convened a national emergency medical services (EMS) stakeholders meeting in April 2014 to discuss the subject of MIH/CP. Previously, the Technical Committee for Emergency Medical Services had reviewed a new project request for a MIH/CP document, though that request was later administratively withdrawn.

These reforms compelled the Technical Committee on Emergency Medical Services to organize a meeting for stakeholders to garner input from a broad group of healthcare professionals and to discuss the possibility for a new request on MIH/CP. The meeting afforded the opportunity to not only learn the opinions of prominent national EMS and healthcare professionals, but also to discuss how the NFPA could assist the community of actors involved in MIH/CP.

Download the report from the national stakeholder meeting (PDF) on mobile integrated healthcare and community paramedicine.

Current document development

Since the stakeholder meeting in 2014, the Technical Committee on Emergency Medical Services has undergone many changes and taken several significant steps to further a useful guidance document for services interested in developing an MIH/CP program.  A new document request submitted and approved by the Standards Council.  The document titled NFPA 451, Guide for Fire Based Community Healthcare Providers is currently in Draft development with over 50% of the document already drafted.  In a recent article published in the Journal of Emergency Medical Services, the committee updated the EMS Community on its efforts and announced its goal of releasing a draft of the document to the public for input by the end of 2017. 

The Technical Committee on Emergency Medical Services has also undergone a large transition so far in 2017. Kyle Gorman, a former vice chair of the National EMS Advisory Council has been named Chair of the committee, leaders from many large national EMS stakeholder organizations have been appointed to the committee, and many more are either in the application process or participating in this effort as guests of the committee. The next full meeting of the committee will be June 13-14 at NFPA headquarters. The meeting is open to the public, please RSVP if you would like to attend. 

Future projects
Technical Committee on Emergency Medical Services has also stated that there is a great need of research to be done related to the provision of EMS throughout the Country and the world. One of the reasons that the MIH/CP guide has been difficult to develop and has been differed in the past is because of a lack of data regarding what are the best means of delivery and resources to utilize for services. Also, the EMS industry as a whole is lacking manageable data to set further national standards and performance measures for services.  The committee has requested that the Fire Protection Research Foundation conduct research on existing HIH/CP programs (below). They are also considering requesting further EMS related research. If you would like to speak with Committee members or have suggestions or questions, please contact John Montes.
Research Foundation report

The main objectives of this Research Foundation project included identifying where mobile integrated healthcare and community paramedicine (MIH & CP) is used in the USA, determine what information is available from those communities, and produce a report to help the NFPA Technical Committee (TC) on Emergency Medical Services (EMS-AAA) develop a document relating to firebased MIH & CP systems. The final report was released in May 2016.


Mobile Integrated Healthcare & Community Paramedicine

Download this infographic. (PNG)