Item 4 - Report on Mobile Healthcare Services Option

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Case Study #5 A 29 year-old single mother of two is getting ready for work and preparing her children for school and daycare when her youngest falls in the hallway, bumps his head on a stool and vomits. This 5 year old boy has a small bump on his head and won’t stop crying. The mother notices the bump and does not know what to do. She has no insurance and is reluctant to move him but feels he needs to go to the Emergency Department. She dials 9-1-1. The call-taker discusses the problem and follows the computer advice to transfer the call to the MediHelp call center to send a Mobile Primary Care Unit (MPCU). The mother is connected to the Triage Nurse who gives her advice on what to do until the MPCU arrives. In 20 minutes, the MPCU Community Health Nurse arrives at the home. The nurse checks the boy who has stopped crying and sends a video image of him to the Medical Control Center for assessment. The other child is put on the bus for school. The nurse and Medical Control Center concur that there are no findings of a head injury. The nurse gives the boy’s mother written instructions for icing the bump and watching for any signs of changes in the boy’s condition. She also gives the mother a call-back number, should there be any complications. After an hour without complications, the mother takes the boy to his grandmother for daycare. Grandmother receives the written instructions and the mother goes to work. There are no further complications. Without MHS the 9-1-1 call would have resulted in the same unnecessary EMS first response and ambulance ride to the ED as in case #1. The $1,200 - $2,000 bill would have been a tremendous burden and quite possibly a bad debt, contributing to the uncompensated care problem for EMS and ED and future credit problems for the mother. The mother would likely have missed an entire day of work. She did not have enough accrued leave time and would not have been paid for the day. 16