Public health at the front door: An MIH model to emulate

In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation’s most forward-thinking mobile integrated healthcare programs. Prisma Health’s team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically. | MORE: How North Dakota EMS is confronting rising pediatric mental health crises  Whether it's addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing. Rob is joined by four key voices from the Prisma Health MIH program: Luke Estes, director of MIH Dr. Mirinda Gormley, epidemiologist and biostatistician Wes Wampler, community paramedic specializing in addiction and infectious disease Parker Bailes, community paramedic and research contributor Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn’t just novel — it’s necessary. This is EMS in its truest public health form. Memorable quotes “You delivered the goods—data-driven, community-connected care — and that’s what EMS in 2025 needs more of.” — Rob Lawrence “When you see some of your people who have a passion for a certain pathway in EMS, you try to give them the reins and say, you're gonna do some good.” — Luke Estes “One of the big things that we learned from his study was that we really needed to go out and make sure everybody was aware that addiction is a disease.” — Mirinda Gormley “If we can gain their trust, there’s a lot more that we can kind of weasel our way into to help them solve and get them on a healthier trajectory.” — Wes Wampler “Walking into the (care) facility with the mindset of, ‘I'm going to do everything I can to keep you here,’ was a big shift for me.” — Parker Bailes “If we can set them up to be successful after they leave the hospital, I think that's the best way to get them reengaged with the hospital.” — Wes Wampler “As their leader … all I have to say is, what do you need? I'm here to support you.” — Luke Estes Additional resources EMS Clinician Perceptions on Prehospital Buprenorphine Administration Programs: Prehospital Emergency Care: Vol 29 , No 4 Implementation Barriers of Prehospital Buprenorphine Administration Programs in the United States: A Scoping Review: Prehospital Emergency Care: Vol 29 , No 4 Using Community Paramedicine to Treat Hepatitis C Virus in Upstate South Carolina - PMC Luke Estes BA, NRP, CCEMTP, PNCCT, FP-C, CP-C | LinkedIn Wesley Wampler | LinkedIn Support for harm reduction by community EMS How does a community re-imagine compassion to avoid crisis whenever possible? Breaking barriers: Hennepin EMS leads the way in safely implementing buprenorphine Episode timeline 00:51 ­– Introduction to Prisma Health MIH & guests 03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction) 05:00 – Dr. Gormley’s public health journey, data-opioid focus 08:00 – Buprenorphine pilot design and research outcomes 10:15 – Challenges: bias, stigma, barriers to addiction care 13:00 – Funding and sustainability conversation 14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care 17:00 – Building trust with vulnerable populations 18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions 21:45 – Alternative destinations, lab draws and high-acuity decisions 25:30 – Training: internal education, ultrasound, medication management 28:15 – Prisma’s med school connection and disaster response evolution 30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams 31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals 35:26 – Final reflections from Luke Estes: passion, team strength and mission 38:00 – Rob’s call to action: “If you want your own Prisma team — start now.” Enjoying the show? Email [email protected] to share feedback or suggest future guests.