Melissa McNally, EMT-P, PA

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Mobile Integrated Healthcare (MIH) Physician Assistant

Like many Evolution Health providers, Melissa McNally began her career as a paramedic. And, as is common with former paramedics, Melissa attributes her success as an advanced practice provider to her urgent care background. “EMS made me a better clinician. It taught me to carefully study environments, be ready for anything, and think outside the box. It molded how I care for patients.

Melissa is now a Mobile Integrated Healthcare (MIH) Physician Assistant working with paramedics and other clinical team members to care for large populations in Florida. Transitioning to an MIH clinical role felt familiar to Melissa. The MIH model of caring for patients in their homes is an EMS component Melissa values. The difference now is she gets to keep them there. Whereas her days as an EMT-P required her to transport patients to the emergency department, now, as an MIH PA, she works with a team striving to mitigate ER visits. “EMS was traditionally a transportation benefit, but we are changing that idea.” Melissa and her MIH team of paramedics and clinicians are providing alternative resources for acute patient care – evaluating and treating patients in their home. Highly-skilled paramedics are providing front-line, in-home treatment in concert with their clinical team members to prevent patient hospitalization – a practice Melissa believes will change not only paramedicine, but the entire delivery of healthcare.

Melissa says the collaboration of MIH providers – from EMS clinicians to PAs – makes this model effective. Integrating clinicians enables more frequent patient touches, early intervention and increased patient satisfaction. “Our MIH model catches patients in all stages of care – prevention, care management, unplanned care and palliative. And we have the right team members to provide care at all of these stages.” However, because MIH is so new, the roles of team members often bleed into one another. But Melissa doesn’t view this as a negative. In fact, this makes her appreciate her EMS background and the skills of her EMS team members even more. “The great thing about starting in EMS is you are familiar with treating all age groups and all degree of incidents. It is a great education in diagnosis and triage of a variety of episodes in many environments.” When paramedics need to perform a minor in-home procedure, Melissa trusts them to do that. And when Melissa needs to put on her EMT-P cap and quickly triage a situation, she is comfortable playing that role. Within this model, all clinicians are able and expected to practice at the very top of their licensure elevating the level of care provided to each patient.

When talking to Melissa it is easy to recognize the influence EMS had on her. Not only did it feed her adrenal cravings – her ED and firefighting shifts fill that void now – it shaped her perspective on patient care. Melissa, having picked up, treated and delivered patients in multiple environments, has a holistic view of healthcare. She knows it isn’t – and to be truly effective can’t be – bound by location or administering clinician title. She knows to deliver high-quality patient-centered care, clinicians in every stage of the continuum must be highly-trained and trusted to deliver and coordinate care in any environment. The MIH model - with providers like Melissa leading the way - realizes this philosophy.