Implementing mobile integrated health for adults with intellectual and developmental disabilities: a qualitative...

Adults with intellectual and developmental disabilities (IDD) experience disparities in access to timely, high-quality acute care. Mobile Integrated Health (MIH), a paramedic-led model that utilizes mobile assets to deliver in-home care in coordination with supervising physicians, may address these care gaps. Its adaptation for the IDD population has not been systematically examined.

The objective of this study was to evaluate stakeholder readiness, perceived barriers, and facilitators for adapting MIH for patients with IDD.

We recruited 2 community paramedics, 5 clinicians, 4 administrative leaders, and 3 caregivers to participate in semi-structured interviews. Interview guides were developed to assess readiness, barriers, and facilitators for implementing MIH for adults with IDD, informed by the Consolidated Framework for Implementation Research. Interviews were analyzed using a hybrid inductive-deductive thematic approach. Findings from the analysis were then integrated into an Implementation Mapping process.

Stakeholders identified three major themes: (1) Effective MIH implementation requires integration with existing systems to support interdisciplinary coordination and sustainability, (2) protocols must be adapted to the behavioral and medical complexities of the IDD population, and (3) MIH overcomes barriers to access and resource utilization and facilitates patient-centered approaches to the care of patients with IDD. Implementation mapping identified multi-level barriers to MIH adoption, including limited awareness, unclear workflows, and funding uncertainty.

MIH offers a community-based approach to patient-centered acute care for adults with IDD. Successful implementation will require coordinated strategies addressing clinical, operational, and policy barriers, emphasizing interprofessional collaboration and sustainable reimbursement mechanisms to support long-term adoption.