Date of Award


Document Type


Degree Name

Doctor of Medical Science (DMSc)


Department of Physician Assistant Medicine

First Advisor

Justin M. Gambini DMSc, PA-C, DFAAPA


Pre-hospital Emergency Medical Service (EMS) systems, including fire departments and ambulance transport services, are increasingly overburdened with high call volumes and unnecessary utilization of services leading to provider burnout, depletion of resources and rising healthcare costs. Many local EMS systems have recognized a need for a more sustainable solution to help reduce the number of unnecessary 9-1-1 calls and transportation to the Emergency Department (ED). Local agencies are beginning to expand the role and scope of practice for paramedics through programs referred to as Mobile Integrated Health – Community Paramedicine (MIH-CP). This new branch of medicine aims to provide patient-centered mobile healthcare, resources and education through the utilization of paramedics in the community. MIH-CP programs have taken flight nationwide over the past 10 years and the number of programs continues to rise. There are a variety of styles of programs due to the diverse needs among local populations. This article focuses on summarizing relevant current literature centered around the effectiveness of MIH-CP programs in reducing unnecessary 9-1-1 calls and ambulance transports. The George Fox University online database library and PubMed were used to gather peer-reviewed literature relating to MIH-CP. A review of medical literature revealed that most MIH-CP programs reported success with their interventions, however there is a lack of consistent and uniform methodologies and measurement standards to accurately quantify or compare each program’s level of success. Overall, MIH-CP programs still offer great potential in being a lasting solution to the overwhelmed EMS system nationwide.