Mobile Integrated Health

The following services are offered by Mobile Integrated Health:

• Case management services: all patients enrolled in the program are assigned to an outpatient high-risk nurse case manager. The case manager will assist patients with finding long-term support and connections in the community. They will also provide education and resources needed for each patient and their support system.
• Skilled in-home care: Community paramedics will visit patients in their home environment to perform skilled care including but not limited to:
  • Wound care and wound vac changes
  • Drain management
  • Ostomy care and management
  • Tracheostomy care and management
  • Diagnosis specific education and medication reconciliation
• Physician oversight: The Mobile Integrated Health Medical Directors provide oversight to patient care.  
• 24/7 hotline: Patients are provided with a phone number to call for non-emergent concerns that is available 24 hours per day and 7 days per week. Patients who are experiencing emergent or life threatening situations are encouraged to call 911 for immediate assistance.

Patients are eligible to be enrolled in the Brown University Health Mobile Integrated Health Program if they meet the following criteria:

• Is a current Brown University Health Hospital patient
• Is a Rhode Island resident
• Agrees to the terms in the Mobile Integrated Health Patient Agreement form

Care Coordination 

Our outpatient high risk case managers work with every patient enrolled in the program to:

• Provide assistance to patients to connect them with their providers and available community resources.  
• Collaborate with the hospitals, home care and DME agencies, as well as provider offices to ensure patients receive holistic care. 

Post-Discharge Support

The Mobile Integrated Health team provides:

• Care to patients after discharge from their hospital stay with the goal of increasing independence with care and avoiding readmission to the hospital. 
• Education on chronic disease management and reinforces hospital discharge instructions

Benefits of the program include:

• Improved access to healthcare in the community
• Reduced healthcare costs for patients and the hospital system
• Flexibility with patients to meet their care needs at home