Mobile Integrated Healthcare (MIH)

Mobile Integrated Healthcare (MIH)


Mobile Integrated Healthcare (MIH) is a novel approach to filling some of the gaps in the healthcare system. It utilizes emergency medical service providers in non-traditional roles to help improve population health, reduce the cost per capita, and improve the experience of care.  The MIH program at MCH is patient-centered and focused around primary care. Our highly educated community paramedics work directly with the patient’s primary care provider (PCP) to increase access to primary care and mitigate transportation and technology challenges.   The MIH program is an innovative and comprehensive program that provides many services to our patients.  MIH works with PCPs to help patients successfully transition from a hospital admission or skilled nursing facility back into the community to prevent readmissions.  Our skilled Community Paramedics can provide support and connect patients to services that have a high number of avoidable emergency department visits.  The MIH program also supports many aspect of primary care by being their eyes, ears, and hands within the patient’s home.   Being a hospital based program has substantial benefits. Our Community Paramedics (CP) are able to document directly in your health record.  This allows real time collaboration between your PCP and the Community Paramedic.  The CP is also able to bring your current medication list, allergies, and past medical history up to date for your PCP.


MCH Community Paramedics have gone through a college-based community paramedic program that includes significant clinical hours in fields such as; primary care, skilled nursing, wound care, and case management.  Because our program is hospital based, our MIH Team has an expanded role beyond the traditional paramedic. This permits them to do such things as collect all types of laboratory specimen, place Foley catheters, address wound care, evaluate home safety, provide health education, immunizations, medication administration, and manage chronic medical equipment.   Our MIH team can bring your PCP to you!  For patients who are lacking the necessary technology for Telehealth, our team will help facilitate these visits with your healthcare provider.  We are also able to obtain vital signs and conduct a physical assessment while we are in your home.  If your PCP would like laboratory samples collected or an intervention provided, the Community Paramedic can perform those during that visit.  This can provide your PCP with significantly more information than they would typically obtain from a standard telehealth visit.   Our MIH program is not a substitute for home healthcare, emergency medical services, or any other service currently available within our community.  We work in collaboration with these agencies to ensure that services are not duplicated and to prevent gaps within services. Often times the CP will recognize the need for home healthcare services during a patient visit and will request the appropriate referral.  Community agencies may also refer patients to the MIH program.

Who can be referred to the MIH program?

The only requirement for patients to be referred to the MIH program is that they must have a PCP here at MCH.  If you are interested in a PCP here at MCH please call (603) 924-4699 x1600.

Who can refer a patient to the MIH program?

Patients can be referred to the MIH program from many different sources.  Any MCH department may submit a referral.  The following external agencies may also submit a referral:

  • Emergency Medical Service (EMS)
  • Specialty services located at MCH
  • Home healthcare

If you have a family member or friend that you feel could benefit from an MIH visit, please reach out to the patient’s PCP office.

How to refer a patient to the MIH program?

MCH departments with access to eCW should submit a referral through that system.  Those departments without access and external agencies should submit a referral utilizing the link below.

Please remember that MIH services can only be provided to patients who have a PCP through MCH.  If you are interested in a PCP here at MCH please call (603) 924-4699 x1645. https://monadnockcommunityhospital.com/referrals/ If you have questions about our program or have an urgent need, please reach out to our dispatch line at (603) 924-4699 x2615.

Meet our community paramedics:

Tom Dardas, CCP-C Tom has been in emergency medical services (EMS) for over 30 years.  He served as a combat and flight medic with the U.S. Army for 14 years deploying to Iraq during the Persian Gulf War.  Tom is a boarded-certified critical care paramedic (CCP-C). He completed his community paramedic clinical rotations here at MCH. Tom has been a Community Paramedic at MCH since the program started in April 2020.

Joshua Patrick, MPSLA, CP-C Josh has been in emergency medical services (EMS) for over 15 years.  He earned a Master of Public Safety Leadership and Administration degree with a concentration in mobile integrated healthcare and is currently a Ph.D. student and active researcher.  Josh is a board-certified community paramedic (CP-C) and an adjunct instructor of community paramedicine.  Josh is currently the Lead Community Paramedic clinician at MCH and has been a part of the time since the MIH program started in April 2020