Mobile medicine: Grady house calls free up ERs for true emergencies

The program saves money and bed space
Illustration by John W. Tomac

Unnecessary emergency room visits place a financial and service burden on hospitals, especially “safety net” facilities that serve large numbers of uninsured patients. A few Georgia institutions are reducing their losses by responding to some 911 calls with teams of healthcare professionals who can treat patients in the field.

This method, called “mobile integrated healthcare,” keeps “frequent flyers” and “over-abusers” out of the emergency department. At Grady Health System, the approach is projected to free up 8,400 hours of annual bed space and save nearly $444,000.

ChoiceCare Ambulance in Central Georgia sends out paramedics, with home visits costing as little as $50; Hall County sends nurse practitioners with its EMS pros. David Kimbrell, the county’s director of emergency management, says, “Our MIH responders can take care of non-life-threatening problems, including writing prescriptions and minor procedures.”

Hall County responders typically go to homes in an SUV or sedan, sans sirens. They are equipped with a mini lab to perform tests and certain treatments. “We are able to bill for less than $500,” says Kimbrell. In contrast, the fee just to transport a patient to the hospital starts at $775 in that area.

Grady’s trial three-week program is now in its second year. Initially focused on mental health, the Grady Upstream Crisis Intervention program has since expanded its reach and now handles more than 1,200 calls a year.

Grady Savings
hours of annual bed space freed up


calls per year handled by mobile program


X-Ray vision
Most patients never meet the doctors who read their x-rays, CT scans, or MRIs, yet radiologists often make critical diagnoses that affect patients’ treatment. To help patients make sense of their results, Dr. Rourke Stay, a board-certified radiologist, founded Lightbulb Radiology, a Columbus-based service that provides online second opinions via GoToMeeting. A personal consult costs $299.

This article originally appeared in our 2015 Health issue.