EMS

Mobile Integrated Healthcare (MIH) is a coordinated, patient-centered, evidence-based, holistic model of care using collaborative, interdisciplinary teams to serve patient needs at the most appropriate level of care at a safe location of their convenience. 

Community Paramedicine (CP) is a segment of Mobile Integrated Healthcare (MIH) that is a provider-led, patient-centered delivery care model using appropriately trained Emergency Medical Services (EMS)  clinicians in an expanded role to render care, facilitate a more efficient delivery of care, and enhance access to community resources that address the social determinants of health.

Physician extension occurs when a licensed physician authorizes a non-physician to act as a “physician extender” to provide medical care to patients directly under the physician's medical license. In traditional practices the physician extender is a nurse practitioner (NP) or physician assistant (PA) operating under a collaborative practice agreement with the physician. 

In emergency medical services (EMS), certified and registered EMS providers, as defined by the National Registry of Emergency Medical Technicians (NREMT), deliver medical care as a physician extender while operating under the direction of a physician, standing orders/protocols, or operational medical direction (OMD). 

In emerging private practices, hospitals, or concierge-like mobile medical care services, the physician extender can include registered nurses and EMS providers with expanded training and authorization to provide a variety of medical services within their scope of practice and as a medical assistant to a physician or advanced practitioner under the same medical direction as EMS agencies and practices.