Factors Impacting the Implementation of Mobile Integrated Health Programs for the Acute Care of Older Adults

Abstract

Objective

Emergency services utilization is increasing in older adult populations. Many such encounters may be preventable with better access to acute care in the community. Mobile integrated health (MIH) programs leverage mobile resources to deliver care and services to patients in the out‐of‐hospital environment and have the potential to improve clinical outcomes and decrease health care costs; however, they have not been widely implemented. We assessed barriers, potential facilitators, and other factors critical to the implementation of MIH programs with key vested partners.

Methods

Professional and community-member partners were purposefully recruited to participate in recorded structured interviews. The study team used the Practical Robust Implementation and Sustainability Model (PRISM) framework to develop an interview guide and codebook. Coders employed a combination of deductive and inductive coding strategies to identify common themes across partner groups.

Results

The study team interviewed 22 participants (mean age 56, 68% female). A cohort of professional subject matter experts included physicians, paramedics, public health personnel, and hospital administrators. A cohort of lay community partners included patients and caregivers. Coders identified three prominent themes that impact MIH implementation. First, MIH is disruptive to existing clinical workflows. Second, using MIH to improve patients’ experience during acute care encounters is key to intervention adoption. Finally, legislative action is needed to augment central financial and regulatory policies to ensure the adoption of MIH programs.

Conclusions

Common themes impacting the implementation of MIH programs were identified across vested partner groups. Multilevel strategies are needed to address patient adoption, clinical partners’ workflow, and legislative policies to ensure the success of MIH programs.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Prior Presentations

This project was presented at the National Association for Emergency Medical Services Physicians (NAEMSP) Annual Conference in January 2024.

Data Availability Statement

The project protocols and data are available upon reasonable request by contacting LO.

Additional information

Funding

The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2TR001454. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.