Mobile health clinics bring important healthcare prevention and treatment services directly to the neighborhoods where people who have more limited access to more traditional forms of healthcare live and work. Mobile clinics can also remove barriers for people who may not feel comfortable accessing care in more formal health settings. By making care more readily available close to home, mobile health clinics can make it easier for people to access routine screenings such as mammograms, preventative care such as flu shots and COVID-19 vaccines and receive diagnoses for health problems such as cancer at the earliest stage.
Exploring the Mobile Health Movement
A 2020 article in the International Journal for Equity in Health looked at data from 811 mobile health clinics to understand who they serve, how they operate, and the role they play within the broader healthcare system. They discovered that on average:
- Mobile health clinics provide 3,491 visits per year
- 55% of clients are female
- 59% of clients are from a racial or ethnic minority
- 41% of clinics serve children, ages 0 to 17 years
- 38% serve persons experiencing homelessness
- 55% serve people with low incomes
- 56% serve people who are uninsured
Some mobile health clinics are independently operated, while others are affiliated with a university or health system. Further, 52% of the mobile health clinics are funded by philanthropy and 45% receive federal funding.
This data provides a brief snapshot of the significant role that mobile clinics play in bringing needed healthcare to communities that might otherwise have more trouble accessing it. The study authors also note the need to continue investing in mobile clinics and other innovative prevention approaches “to expand the boundaries of the traditional healthcare system.”
Improving Community Health Results in Cost Savings
“Mobile clinics are an essential part of our nation’s healthcare system,” said Mollie Williams, DrPH, Executive Director of The Family Van, a community program of Harvard Medical School. Services provided by The Family Van to people in the Boston area include screenings for diabetes, high blood pressure, depression, and other common chronic conditions; lifestyle counseling; and health education.
The Family Van measures success by tracking services provided and demographics of the people served, as well as measuring clinical outcomes like reductions in blood pressure over time. They have also studied the cost savings associated with the preventive services they offer. According to Williams, over a five-year period, The Family Van recognized $23 in healthcare savings for every $1 they spent on preventive care. In addition, an estimated $2.8 million was saved in avoided emergency department costs.
The Family Van relies mostly on philanthropic funding, and its services are provided to clients at no charge. Yet, Williams pointed out that many other mobile clinics do bill for their care, so insurers can—and in many cases already do—play an important role in the mobile health sector. “Payors understand the benefit of prevention. The incentives they establish for healthcare organizations, such as reductions in readmissions, delivering recommended preventive services to their members, and patient engagement, are all enhanced by mobile health programs,” she stressed.
Addressing Socioeconomic Disparities
In 2021, The Family Van served fewer people than in past years due to COVID, but the team continued to stay connected to its clients during the shutdowns. “We made nearly 1,000 phone calls to check in on our clients. We mailed and hand-delivered more than 3,000 emergency supplies, including reusable masks, diapers, formula, hand sanitizers, grocery gift cards, and other essentials,” Williams said.
“Our program works closely with other healthcare providers, community programs, housing and food organizations, and neighborhood leaders. It also collaborates with local businesses and places of worship, reaching people where they live, work, play, and pray,” she added.
Using Community Health Workers to Build Relationships
Although comprised of a multidisciplinary team that also includes registered dieticians, health educators, and other health professionals, The Family Van is led and operated by community health workers (CHWs) who speak the languages that are predominantly spoken in the areas they serve, including English, Spanish, Haitian Creole, Portuguese, and French. Volunteers contribute additional languages, including Arabic and Vietnamese. People feel more comfortable having CHWs at the helm, Williams said, because The Family Van’s CHWs come from the communities they serve.
“Our CHW-led model allows us to build trust and connection in ways that mobile health clinics operated by doctors and other healthcare professionals may not always be able to accomplish,” she explained. “And because we travel directly to underserved communities, we help reduce the barriers of time, transportation, childcare, and other logistics that can get in the way of obtaining much needed healthcare,” she pointed out.
Another Mobile Health Clinic Tackles Community Health
Created by Dr. Frederick Altice of the Yale AIDS Program at the Yale School of Medicine, the Community Health Care Van (CHCV) provides mobile health services to people in the New Haven community. This model, which is run by healthcare professionals and includes CHWs as part of its multi-disciplinary treatment team, serves medically and socially marginalized individuals.
“We see people who use drugs, people without health insurance, undocumented individuals, sex workers, and those with addiction disorders, unstable housing, or former incarceration,” explained Leslie Sude, MD, Yale Medicine pediatrician and associate professor of clinical pediatrics at Yale School of Medicine.
Clients receive basic primary care; harm-reduction services for substance use disorders; rapid screening for infectious diseases transmitted through sex and injection drug use; and access to one of the largest syringe exchange programs in the state. They are also referred to addiction services, primary care providers, and mental health clinicians.
In a typical year, the CHCV serves roughly 1,400 individuals as well as more than 400 clients in their syringe service. During the pandemic, the program added early postpartum support to women and newborns, as well as mobile flu and COVID vaccination clinics, and supported an additional 2,000 visits for those services. Services are covered through a mix of insurance reimbursement and grant funding.
Using a Mobile Health Clinic Model to Support Population Health
Sude stressed that the mobile health clinic model fills an important gap in the medical system. “Health systems typically expect people to receive care at places we assign, at times we designate, with little flexibility for lateness and missed appointments. It is a very institution-centric model that does not meet the needs of many who are in desperate need for care,” she said.
By bringing care to residents directly, the CHCV addresses health inequities and also provides important support for people who are less served by the traditional system. This makes the New Haven community healthier overall.
Sude also said that the lessons learned by the CHCV and similar programs provide an important model for health systems considering implementing similar efforts, as well as validation for insurers who are currently investing in such programs to show they are making a difference. “Investing in care systems [such as Harvard’s and Yale’s mobile van models] that reduce those costs for the individuals served provides returns on those investments over the long term in multiple ways,” she added.