August 26, 2015
Mobile Health, Part II: Bringing Care to Underserved Communities
BY Mary Mahoney
In today’s society, we are awash with health and fitness information on our mobile devices: apps, text reminders for doctor appointments and medical websites. Less often discussed is the phenomenon of mobile health clinics.
These clinics-on-wheels can provide an efficient and effective way of delivering medical care to disadvantaged communities, raising health awareness and providing impoverished patients with preventive care, diagnoses and treatment.
Like health apps, mobile health clinics aim to reach more people with more conveniently delivered health care. Some mobile health clinics are privately operated and others are hospital-funded. They originated to serve rural, isolated and low-income areas.
In addition to administering routine check-ups and blood tests, some of these clinics also offer dental and ob/gyn care, counseling services and imaging. Since many are supported through grants, their services are usually provided at low to no cost to patients.
Orlando Health’s Teen Xpress, part of the Arnold Palmer Hospital for Children in Florida, is hospital-funded. It features a well-equipped, 40-foot bus capable of providing primary-care services to adolescents and teens including physicals, immunizations, mental health and nutritional counseling.
Kaiser Permanente brings its medical van to the offices of its corporate clients to provide adult and pediatric care, chronic care, blood and urine collection and processing, glucose testing, audiometry, gynecological care and immunizations.
While apps are relatively new, the mobile health concept has been around for decades. Arizona was an early proponent and finds the concept still works well today. The University of Arizona Mobile Health Program serves about 2,400 uninsured and under-insured people, plus those that don’t have regular access to health facilities. The program also offers group prenatal care appointments for expectant mothers.
In Boston, mobile health units called The Family Van, sponsored by Harvard Medical School, provide an alternative to emergency room visits for patients with routine medical needs. Based on an average emergency department visit cost on average $474 in Massachusetts, the vans could save about $1.4 million in costs based on 2,851 avoidable emergency department visits annually, according to a report by WBUR-FM.
In 2012, the Massachusetts Department of Public Health published a five-year plan to address chronic disease prevention that recommended increasing the number of mobile health clinics.
Harvard Medical School developed a Mobile Health Map that pinpoints 2,000 mobile clinics serving 7 million people annually.
Some cite health reform as an opportunity to put more mobile health clinics into action. According to Mobile Health in the Era of Reform, published in the American Journal of Managed Care, recent reforms to the delivery system and health insurance coverage “have the potential to improve the integration of mobile clinics into existing care delivery structures.”
Mobile health clinics also may yield collateral benefits. According to an article in Slate, patients who have their blood pressure checked may “open up more and talk about other health concerns” as well as social and mental-health issues and family problems. As Nancy Oriol, a professor of anesthesia at Harvard Medical School and co-founder of the Family Van points out, “people come on the van with their lives.”