The City of Gainesville is the county seat of Alachua County, Florida, and the largest city in North Central Florida with the Gainesville metropolitan area having a population of 339,247 in 2020. Gainesville is home to the University of Florida, the fourth-largest public university campus by enrollment in the United States.

The City of Gainesville is the county seat of Alachua County, Florida, and the largest city in North Central Florida, with the Gainesville metropolitan area having a population of 339,247 in 2020. Gainesville is home to the University of Florida, the fourth-largest public university campus by enrollment in the United States.

Gainesville Fire Rescue is a leading provider of RAPID (Responsible, Accountable, Professional, Innovative, and Dedicated) fire/rescue services for the City of Gainesville. Gainesville Fire Rescue (GFR) protects and serves through community involvement, education, prevention, and rapid intervention by professionals committed to excellence.

GFR has nine fire stations, providing fire protection and Advanced Life Support service to the citizens of Gainesville. GFR is an all hazards response department, including a Hazardous Materials team, a Technical Rescue team, a SWAT medic team, Airport Firefighting team, and a Community Resource Paramedicine Program (CRP). The Community Resource Paramedicine Program is a community Mobile Integrated Health program that combines case management and paramedicine to assist underserved and at-risk populations.

Addressing the challenges facing the metropolitan area, this Mobile Integrated Health program operates with four branches.

• Chronic Disease Management
• Recovery Response Program
• Homeless Outreach and Prevention
• Community Health and Wellness

Each CRP team consists of a Firefighter-Paramedic and a Resource Technician who visit and provide service to neighbors in need. With the previous system, documenting, sharing and reporting were very cumbersome and time consuming for the teams. They carried patient files to each neighbor’s home, and returned to the office to complete reporting requirements at the end of each day.

Important Requirements

Customization. Realizing the field of Community Paramedicine and Mobile Integrated Health (MIH) is still in its infancy, the evaluation team made flexibility and customization a high priority. They were looking for a company with a track record of innovation and a willingness to respond with new features and capabilities; a company with the ability to address social determinants, adopt evolving strategies in risk mitigation, and support co-response and multidisciplinary teams.

A priority in the software is the ability to customize the interventions and assessments over time. Whereas pre-hospital and EMS providers have traditionally taken a patient’s vital signs, such as blood pressure and pulse, the MIH program may conduct a myriad of assessments such as fall risk, depression, substance abuse, and disease-specific assessments. Additionally, the CRP team members were looking for ways to create workflows and question sets to help guide patient care plans.

Case Management. The importance of documentation within case management is critical. As MIH programs grow in diversity, connect communities, and break down silos across multidisciplinary care teams, flexibility in charting and reporting is greatly increasing.

Gainesville Fire Rescue paramedics intake patients, assess their need for resources, and then guide them through the adoption and use of those resources over time. Some patients require highly involved care plans with daily outreach. Others may only need to be connected with a primary care provider. These scenarios require a management platform that provides for the monitoring of patient progress, tracking long-term goals, keeping notes within a longitudinal record, and sharing access with providers.

Reporting. New programs in their infancy require data for the purpose of funding and quality assurance. Gainesville Fire Rescue’s CRP program needs user-friendly reporting capabilities that allow the program to look at the public health big picture data, such as looking at populations by intervention, address, social/medical problems, and other categories. In addition to the big picture data, the CRP program needs to produce reporting and trending on individual cases.

Detailed Specifications. 57 additional requirements were outlined, such as:

• Secure, HIPAA compliant, cloud-based software
• Universal device support
• Simultaneous, multiple-user access to patient records
• A library of standard and custom multidisciplinary assessments for measuring social, mental health, and wellness indicators
• Risk analysis tools for evaluating social determinants of health, wellness, and medical problems
• Longitudinal patient records to view, track, and trend the progress of discrete health metrics over time
• The ability to assign patients to categories and programs
• Secure appointment scheduling
• Appointment confirmations and reminders for patients
• Electronic signatures
• The ability to track patient history, family history, medications, and allergies
• Flexible document management

Evaluation Criteria

There were several metrics guiding the selection criteria:

Technical Qualifications. This evaluation focused on the experience of the company, the experience of the implementation team, and the experience of support personnel, along with the company’s record of success in regard to this specific area of expertise.

Written Proposal. This evaluation focused on the company’s understanding of the project and approach as expressed within the written proposal, including how effectively the requirements of the scope of services had been addressed. Additionally, attention was given to companies having prior experience working with state and local governments in Florida.

Presentation & Interview. This evaluation focused on the presentation of both the company’s technical qualifications and their approach to the project. Greater emphasis was given to the company’s understanding of the project, clinical processes, administrative work flow, and the response to questions.

Price. The cost of the solution was not of great importance to GFR. Price was responsible for only 30% of a company’s evaluation score.

Other factors. Other factors included: extensive security and compliance evaluation, systems and up-time reliability, business continuity and sustainability, and several other factors.

The Award and Respondents

After an extensive review of several respondents, the contract was awarded to HealthCall for achieving the highest score relating to their expertise, the usability and flexibility of their interface, and fulfilling all of the priority requirements.

At the time of writing, Gainesville Fire Rescue and HealthCall’s implementation team are working through the configuration of the platform, implementing and testing GFR’s custom assessments. All EMR functionality and standardized assessments are available to GFR’s team to utilize with patients today.