Building Continuity of Care with Mobile Health Clinics

A mobile health clinic provides innovative and flexible healthcare delivery to vulnerable, rural, urban and generally underserved populations. Though often misunderstood, and sometimes not fully utilized, mobile health units can provide continuity of care in a number of ways, including:

Being entrenched in a community and leveraging local assets such as school systems, area hospitals, doctors, businesses, chambers and other government institutions, MHCs provide a much needed service to those individuals who may otherwise fall through the cracks.

Going Beyond a One Time Health Screening

Though the program administrators can have all the best intentions, using Mobile Health Clinics to provide continuity of care is not always easy.   Such barriers can be within the population being served, such as homeless people who are frequently on the move, to others who are not adequately connected to local health systems.  Without the connection and support of local clinics, pharmacies and hospitals it is difficult or often impossible for Mobile Health Clinics to track patientMobile Health Clinic_Univ. of Texas_Rio Grand Valley referrals, which is key to continuity.   Attempting to make direct connection with the patient by calling or emailing to confirm that they followed through on a referral can go unanswered.  It is only when the MHC has established solid, direct relationships with the referred organizations, doctors or dentists that they can begin to establish continuity of care, including  communicating patient status back and forth.  The patient may go to the referred doctor for instance, but then re-engage with the MHC for a follow-up screening.

For instance, in typical situations when a person visits their general practitioner for a physical examination, the GP will inquire if the patient is currently seeing other specialists, such as a psychiatrist, pain management or cardiologist.  The GP will then seek written permission from the patient to communicate with the other doctors to ensure everyone is on the same page in treating the patient.  This is an ideal model of continuity of care.  However in the world of Mobile Clinics, it is not always as easy.  That is why establishing relationships in the community is vital.  And when the MHC presents themselves to their network as a supportive extension, not a replacement of services, the facilities and practitioners are more receptive and do not feel their practice is being threatened by outside competition.  After all, everyone in the network is responsible for delivering the best healthcare possible to all people in their community in any way they can, regardless of the patient’s social status.

Establishing Trusting Provider and Client Relationships

When a Mobile Health Clinic successfully establishes its role in the community, and becomes a trusted advisor to their constituents, they have a higher likelihood of fostering trusting relationships with their patients.  In addition, the patients often feel more comfortable with the MHCs’ informal, familiar environment at a convenient location close to home.  And the staff in Mobile Medical Units are unique individuals, able to work well with each other in close confines and extend that level of comfort to their patients, who appreciate the staff’s willingness to come into their communities.  It provides a deeper sense of caring, which in turn develops a level of trust which helps individuals feel more comfortable about seeking healthcare services. 

The case has been made that when a MHC utilizes its mobility and a variety of location stops it has a significant impact in facilitating trusting relationships in the community.  Consistently traveling to familiar neighborhoods on a regular schedule gives people a comfort level that they can depend on.  Regularly visiting schools, businesses, shopping centers, parks and other areas in people’s neighborhoods builds trust.  And utilizing the space in the MHC truck or van to create a friendly and comfortable atmosphere provides an ideal blend of social and health care space, providing an intimate setting that is welcoming and not intimidating.

Mobile Health Vehicles are in a unique position to regain the trust of disenfranchised people to give them the reassurance they can have personalized health care service and encourage them to reconnect for regular care.

MHC San Antonio VAMCAccording to The American Journal of Managed Care “mobile clinics represent an integral component of the healthcare system that serves vulnerable populations and promotes high-quality care at low cost. There are an estimated 1500 mobile clinics receiving 5 million visits nationwide each year.  Mobile clinics improve access for vulnerable populations, bolster prevention and chronic disease management, and reduce costs. Expanded coverage and delivery reform increase opportunities for mobile clinics to partner with hospitals, health systems and insurers to improve care and lower costs.

Mobile clinics have a critical role to play in providing high-quality, low-cost care to vulnerable populations.  The post-reform environment, with increasing accountability for population health management and expanded access among historically underserved populations, should strengthen the ability for mobile clinics to partner with hospitals, health systems and insurance companies to improve care and lower costs.”

Conclusion: Continuity of Care with Mobile Health Clinics Saves Money

As reported by The Pew Charitable Trusts, a group within the renowned Pew Research Center, Dr. Anthony Vavasis of Mount Sinai Beth Israel in New York City has studied the impact of mobile clinics and reported that they “help health systems avoid the “million-dollar patient” — patients who make their first contact with the health care system when a serious condition develops and medical attention becomes so urgent they eventually go to the emergency room.  Because of repeated ER visits, the cost of treating related complications can skyrocket over time. However, “If you build connections early on (between MHCs and their community), then you can avoid having them come to the emergency room for complications later,” said Dr. Vavasis.

Similarly, Mobile Care Chicago’s Asthma Van program provides care to more than 6,000 underprivileged school students in Chicago each year.  They have found success in identifying asthma related issues early on and diverting patients from the emergency room.  According to Matt Siemer, Mobile Care Chicago’s executive director, their organization started working with local hospitals and health plans to target specific ZIP codes where high concentrations of children cycle through the ER for asthma-related issues. Mr. Siemer estimates that their Asthma Van program produces at least $450,000 a year in savings through ER diversions alone.

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