Hospitals and health systems, in a quest to improve health and reduce costs, are finding that mobile clinics can help on both of those fronts. They can boost access to patients who otherwise might only get care in an emergency department, and can offer specialized preventive and primary care that otherwise might be difficult or impossible for some people to access.
Already growing in use — there are roughly 2,000 by one estimate — mobile clinics got a boost from an Institute for Healthcare Improvement effort. The IHI undertook a three-city tour in early March designed to increase awareness of the clinics as a possible key component in a transformed health care system.
Like a lot of things that are happening in health care, the growth of mobile clinics can be attributed to the industry's focus on population health, and often are operated by two or more organizations' combining their resources.
"Mobile health clinics have been managing populations right under the nose of the traditional health care model for years and years now," says Niñon Lewis, a director for IHI. "And now, because of that shift to population management and population health, we're finally seeing these other stakeholders and other community supporters think through what it means to deliver care in a new way."
Mobile clinics are turning out to be one of the answers for many organizations. Hospitals, community health centers, public health departments, churches and social services groups are melding their expertise in different ways to maximize the benefit of the clinics.
Bon Secours Virginia Health System has had mobile clinics since 1984 and recently added its fifth, under the "Care-A-Van" name, says Beth Merchent, vice president for Bon Secours Richmond Health System. In addition, the effort plans to add another vehicle focused on improving nutrition in areas that don't have access to healthy foods.
Bon Secours, which funds its vehicles with a combination of affiliated foundation money, grants, donations and the hospital, offers care to patients without insurance at no charge, she says. In addition, translators are offered for the 60 percent of patients who speak Spanish.
Recent research supports the use of mobile clinics. A study of literature and clinic data collected by the Web-based Mobile Health Map project and published in March by the American Journal of Managed Care found value with the approach. "Mobile clinics have a critical role to play in providing high-quality, low-cost care to vulnerable populations," the authors wrote.
Another study, published in January in Health Affairs, found that a mobile clinic in Massachusetts provided blood pressure screening and counseling, and reduced the risk of heart attack and stroke by 32 percent and 45 percent, respectively.
Merchent says she would recommend the approach to other health systems' looking to manage care across populations. Mobile clinics eliminate barriers — such as for patients who lack transportation or insurance. With the assistance of local community members, they also reach people who otherwise are reluctant to get primary care, she says.