Part 2: Mobile Health Clinics Offer a Wide Variety of Services

Here’s a sampling of some of the mobile health programs across the country

Editor’s Note: This list accompanies this story. Part 1 of this list can be found here.

With help from the Mobile Health Map and The Family Van at Harvard Medical School, HealthLeaders has compiled short profiles of 11 mobile health programs around the country.

OhioHealth Wellness on Wheels

OhioHealth Wellness on Wheels, a program of Columbus, Ohio-based OhioHealth.

Q. Describe your program, why it's different or innovative, who it serves, how many care providers it features, and how this is improving healthcare access and/or clinical outcomes.

OhioHealth Wellness on Wheels (WOW) is just like a normal doctor’s office, but it meets our patients where they are, delivering primary care, women’s health services, and prenatal care regardless of ability to pay. We have three mobile units, each with two full-service exam rooms and the capabilities to provide prenatal care, primary care, and ultrasound lab services as other wellness services. All mobile clinics are staffed with a provider, nurse, medical assistant, social worker, community health worker, and driver.

Our program is unique from many other mobile unit programs as we offer a patient-centered medical home through a team-based approach, led by a provider, to ensure comprehensive and continuous medical care to patients. WOW serves as a connection point for patients who are seeking services to address various social determinants of health, such as education, food, housing, insurance, and transportation, as well as needing pediatric care, resources to address abuse and behavioral health issues, and much more. To date, 59% of WOW patients screened positively for a social need and were referred to community resources for support.

Our program currently serves vulnerable communities throughout central Ohio. The care model focuses on scheduled appointments (rather than walk-ins), community engagement, chronic disease management, and the use of a community health worker to help understand and meet the needs of our patients.

Amid rising infant mortality rates across the state, WOW has provided comprehensive prenatal, postpartum, and women’s healthcare to women residing in Franklin County’s infant mortality “hotspots.” As a result, WOW programs have an infant mortality rate of 5.3 per 1,000 live births, below the Center for Disease Control and Prevention’s Healthy People 2020 targets and the infant mortality rate in Franklin County, which is 6.7 per 1,000 live births. Our programs also demonstrate impact through reduction in neonatal intensive care unit (NICU) admissions in the communities across central Ohio and helping babies reach their first birthdays.

Wellness on Wheels Primary Care also demonstrated a positive impact on access to care through significant reduction in emergency department use. Over the last five years, visits to the ED by WOW patients have decreased 50 percent within 90 days of establishing care through WOW.

Q. What kind of technology do you use?

Our mobile units are resourced with the same registration and clinical technology seen in our brick-and-mortar clinics. Our team uses Epic as their electronic medical record platform, and our ultrasound images are digitally transferred to the EMR for interpretation and storage, as are EKG and spots vitals units. For connectivity our mobile units use a wireless WAN and jetpacks. Additionally, we have security cameras on the outside of the mobile units to ensure safety of patients and staff. To assist with fleet management our units are equipped with the Verizon Connect Fleet Tracking system.

Q. Why did you choose to launch a mobile program? How does this work better than a brick-and-mortar clinic or virtual program?

In 1993, Wellness on Wheels was created to provide comprehensive prenatal and postpartum care to high-risk and underserved women, especially teens, in central Ohio to improve birth outcomes and prevent NICU admissions. This project was originally referred to as Wellness on Wheels/Project to Reduce Infant Mortality (WOW/PRIM).

WOW was designed as a mobile doctor’s office to provide prenatal care, health education, and psychosocial counseling to pregnant women ages 12 to 44 in the low-income areas. WOW enabled pregnant women to have the quickest available prenatal care appointment, thereby offering early prenatal care that they might not have otherwise had. At that time, appointments with WOW were made by calling directly or through StepOne, a dedicated phone service for scheduling appointments with non-profit prenatal care clinics, a convenient scheduling method that continues today.

Over the years, it became evident that there was a shortage of primary care providers across the United States, and Columbus was no different. OhioHealth noted several areas with limited access to primary care and a tendency to overuse emergency room services for primary care needs. OhioHealth had extensive experience in mobile outreaches, but none that were focused on primary care. Through a partnership with Huntington National Bank, we started Wellness on Wheels Primary Care. This outreach has been serving the Hilltop and Linden communities of Columbus for the past five years and provides a care team focused on embedding themselves within the community and gaining the trust of those who may not otherwise seek care.

Q. What are the biggest challenges this program faces?

The biggest challenge OhioHealth Wellness on Wheels faces is ensuring that our programs can be sustained due to rising operational costs, the increased cost of healthcare, and the augmented need seen throughout the community. Additionally, in staffing our driver/registration position it has become a challenge trying to find CDL-A qualified drivers with the desire to serve the community.

Q. How is this program supported so that it is sustainable?

OhioHealth Wellness on Wheels has a mixed funding model of philanthropic, grants, and sponsorship support. We use grant funding and generous support from OhioHealth to operate as a physician office for those patients without insurance.

Q. How are patients charged for healthcare services? Do you work with payers?

Wellness on Wheels is a no-barriers-to-care model and will serve patients no matter their ability to pay. Our program does register patients who have insurance under their provider, while for the uninsured and underinsured we have a fund through the OhioHealth Foundation that supports the cost of their care. We provide physician visits, ultrasound and lab work to patients without insurance at no cost to them. One key initiative of our community health workers is to identify all patients who qualify for insurance and assist them with the enrollment process.

Q. How do you let people know when and where you'll be located? How do you market your services?

We use OhioHealth’s website for an external audience (Wellness on Wheels | OhioHealth) that promotes our programs and lists our contact information as well as clinic locations. Additionally, our team does grassroots marketing through site visits to community-based organizations, community partners, and events. We distribute brochures, hot cards, and flyers to promote and build awareness of our programs. We also find that word of mouth from our established patients is our best form of marketing.

Q. Do you partner with local health systems, primary care providers, health clinics, or other programs?

Yes. Wellness on Wheels mobile programs are part of the OhioHealth enterprise care system. Our comprehensive primary care uses a medical education model with a family medicine resident and attending physicians from three residency programs working in collaboration with the WOW team. Since 1993, community partnerships have been key to the success and sustainability of Wellness on Wheels. Columbus City Schools, Columbus Public Health, Directions for Youth, Central Ohio YMCA, and the Center for Healthy Families are just a few of our committed local partners. 

Q. How might this program evolve? What new technology or strategies would you like to employ in the future?

We would like to expand the use of sprinter vans to support community health workers and social services and expand our geographical reach. Additionally, we would like to implement addiction medicine and behavioral health services into mobile programs, especially after testing a few successful pilot programs.

Q. What is the one thing about this program, good or bad, that has really surprised you? Something you didn't expect to see or experience, an unusual case or treatment, a challenge or barrier you didn't expect to face or didn't expect to be so tough, etc.

Over the years, the WOW team has been heartened to see how women have trusted the comprehensive care team to support their birth experience enough to return for multiple pregnancies and prenatal care. This example demonstrates the impact of years of trust building and how the care team ensure every patient is treated with dignity and respect.   

The Night Ministry

The Night Ministry, Chicago, Illinois.

Q. Describe your program, why it's different or innovative, who it serves, how many care providers it features, and how this is improving healthcare access and/or clinical outcomes.

The Night Ministry’s Health Outreach Program brings free healthcare and supportive services directly to Chicago residents who are unhoused or experiencing poverty. The program is unique in its mobile approach to serving patients who face many barriers accessing traditional healthcare and social services. Through consistent outreach, the provision of resources such as food, clothing, tents, and harm reduction supplies, and a compassionate, nonjudgmental approach, the program staff build relationships with patients, earning their trust as a gateway to providing care and connecting them to such resources as primary care clinics, substance use disorder treatment, and more stable housing.

There are three main components to The Night Ministry’s Health Outreach Program: The Health Outreach Bus, Street Medicine, and CTA Outreach.

The Health Outreach Bus visits Chicago neighborhoods with disproportionate rates of homelessness and poverty during the evenings and the weekends, when clinics and social services agencies are generally closed. Street Medicine visits encampments and other areas of the city where unsheltered individuals are living. The CTA Outreach component connects with unhoused individuals who ride public transit for shelter by bringing health care and outreach services twice weekly to select CTA train stations.

The Night Ministry’s Health Outreach Program direct-service staff include two-full time and one part-time nurse practitioners, three volunteer physicians, three case managers, a substance use specialist, and several outreach professionals.

In the last fiscal year, the program’s medical professionals provided more than 2,000 free health assessments. More than half of those assessments resulted in a patient being treated for a medical condition that would have otherwise been untreated. The program also prevented more than 380 trips to the emergency room, saving the public health system an estimated $350,000.

Q. What kind of technology do you use?

Our medical and case management professionals use the AthenaPractice electronic health records system to document their work. Efforts to Outcomes is another platform we use to document outreach data.

With regard to medical technology, conducting outreach in mobile units can be limiting compared to a brick-and-mortar setting. We have recently acquired EKG machines and have an emergency defibrillator. If more extensive equipment is needed for patient care, individuals are referred to primary care, specialty care, or the emergency room.

Q. Why did you choose to launch a mobile program? How does this work better than a brick-and-mortar clinic or virtual program?

The Night Ministry launched and continues to expand its Health Outreach Program because the patients it serves face multiple barriers to accessing traditional healthcare services, from lack of healthcare insurance and transportation to discrimination during previous encounters with the healthcare system. Bringing care directly to where patients live helps address some of these barriers.

Q. What are the biggest challenges this program faces?

The biggest challenges stem from patients not having housing or being unstably housed, which can hinder the ability for them to recover from or manage their health conditions. Inadequate rest, limited access to hygiene resources, polluted living environments, and the loss of medications are among the conditions that compromise patients’ health. In addition, follow-up with patients can be difficult due to their lack of a permanent, fixed address.

Q. How is this program supported so that it is sustainable?

The Health Outreach Program is supported through various revenue streams, including grants from private foundations and government agencies and donations from corporations and individuals. The Night Ministry’s Philanthropic Engagement Department is responsible for ongoing cultivation and stewardship of these funders and securing the funding necessary to operate the program.

Q. How are patients charged for healthcare services? Do you work with payers?

The Night Ministry’s Health Outreach Program operates as a free and charitable clinic and does not charge for its services.

Q. How do you let people know when and where you'll be located? How do you market your services?

Consistency of presence is one of the key tools in connecting with patients. The Health Outreach Bus follows a set schedule, visiting locations on the same day and time on a weekly basis. The CTA Outreach Program also operates at the same public transit stations every week. While the Street Medicine Program operates with more flexibility in its schedule, it regularly visits areas where patients are located, and often coordinates visits by communicating directly with patients. The vehicles used by the program, including the Health Outreach Bus and Street Medicine Van, advertise the services provided. In addition, The Night Ministry builds relationships with agencies and organizations across Chicago that refer patients to our Health Outreach Program.

Q. Do you partner with local health systems, primary care providers, health clinics or other programs?

We regularly refer patients to other healthcare clinics and service providers for further care. We have also established relationships with teaching hospitals in the Chicago area which allow for medical residents to further their training and gain experience in caring for unhoused populations while enhancing the capacity of The Night Ministry to provide services.

Q. How might this program evolve? What new technology or strategies would you like to employ in the future?

The Night Ministry’s Health Outreach Program continues to evolve in many ways, from substance use programming to hiring practices to mental health and programmatic service expansion. We are growing substance use programming by building referral relationships for supportive services, distributing harm reduction supplies, and educating our clients on safe drug use. And for the first time, we are hiring a psychiatric nurse practitioner to bring mental healthcare directly to our clients.

Q. What is the one thing about this program, good or bad, that has really surprised you? Something you didn't expect to see or experience, an unusual case or treatment, a challenge or barrier you didn't expect to face or didn't expect to be so tough, etc.

We are sometimes the only way that people access medical or housing support. We always ask clients where they would go if The Night Ministry wasn’t there to provide services. We find that people avoid seeking support for many reasons, including prior mistreatment, lack of transportation, fear of having their belongings stolen, or separation from a pet or partner. By going directly to clients and establishing trust, clients are more likely to work with us for the long term in navigating the often challenging housing system and securing long-term solutions.

The Community Health Care Van

The Community Health Care Van, operated by Yale University's Center for Clinical and Community Research, New Haven, Connecticut.

Q. Describe your program, why it's different or innovative, who it serves, how many care providers it features, and how this is improving healthcare access and/or clinical outcomes.

Since 1993, the Yale Center for Clinical and Community Research (YCCR) has operated the Community Health Care Van (CHCV, a 40-foot mobile medical clinic that functions alongside a minivan and storefront office to provide harm reduction and other medical services in New Haven, Connecticut.

The CHCV has long delivered accessible and barrier-free harm reduction and healthcare services at the doorsteps of the community, with an emphasis on New Haven’s most vulnerable neighborhoods. The CHCV served 1,574 clients in 2021. A rotating trio of providers staffs the CHCV throughout the week, alongside two medical assistants and several office staff.

The CHCV serves a significant population of unstably housed/homeless individuals and people who use drugs (PWUD), as well as individuals transitioning from incarceration or treatment programs back to the community. More than 30% of CHCV clients report unstable housing or homelessness, and nearly half experience food insecurity. The CHCV is positioned to meet the needs of these community members, offering services in primary and preventive healthcare, flu and COVID-19 vaccines, HIV care, substance use disorder treatment, and care coordination to stabilize those in crisis or in need. Additionally, the CHCV operates one of the largest overdose education and naloxone distribution programs in the state.

In response to the COVID-19 pandemic, the CHCV expanded its mission to create the Mother-Infant Program (MIP), a mobile unit providing postpartum care for birthing parents and infants with health-related social needs. The MIP addresses health inequality, maternal mortality, substance use, and access to care, and seeks to address the burden of social determinants of health. The MIP aims to decrease adverse maternal and infant outcomes while simultaneously increasing basic needs support.

Q. What kind of technology do you use?

Our 40-foot CHCV has a modem allowing internet access in the van. We use three desktop-style computers on the van, as well as a laptop, which provides us with access to our Epic electronic heath record (EHR) platform. We leverage a working agreement with American Medical Response (AMR), an emergency medical services company, to rent one of their box trucks, which we have retrofitted to provide a space in which to service MIP clients. On the MIP van we use a cellphone hot-spot in order to access our EHR.

Q. Why did you choose to launch a mobile program? How does this work better than a brick-and-mortar clinic or virtual program?

The CHCV has a trusted relationship with the New Haven community, a city profoundly impacted by poverty, substance use, homelessness, and incarceration. It is the 7^th poorest city in the US for its size, with more than 25% of its residents living in extreme poverty, often geographically remote from traditional healthcare settings. The mobile nature of the CHCV and minivan allow our team to frequent underserved areas, such as homeless encampments, shelters, hotels known for drug use, residential neighborhoods, and business districts.

We have found that low-barrier access to healthcare increases the use of services amongst our patients. With specific reference to postpartum care, 40% of women do not attend their traditional brick-and-mortar six-week post-partum visit. By comparison, mothers who are seen by the MIP demonstrate an appointment no-show rate of about 4%.

By taking a focused approach on meeting patients at their doorsteps, providing nuanced care, and assisting them in navigating the healthcare system, the CHCV and MIP provide an innovation in service delivery that directly confronts traditional barriers to healthcare access.

Q. What are the biggest challenges this program faces?

Long-term funding and hospital system buy-in.

Q. How is this program supported so that it is sustainable?

The CHCV team continually applies for a mix of research and service grants to support our program. Including federal, state, and philanthropic sources, we piece together various funding to support our staff and the costs of running the CHCV. Clinical billing offsets a small percentage of this but we could not operate the program without grant and philanthropic funding.

Q. How are patients charged for healthcare services? Do you work with payers?

Patients are never charged for CHCV or MIP services. If they have insurance, a bill for services will be sent to their carrier, but patients are never responsible for services provided by CHCV. We work closely with a CHCV-specific billing team to ensure that services are properly billed. Our medical case managers help patients access patient assistance programs to pay for medications when necessary.

Q. How do you let people know when and where you'll be located? How do you market your services?

The CHCV is a longstanding fixture in New Haven, with most of our clients having accessed our services for many years. We keep the same weekly schedule, at the same locations. Print schedules are handed out in our storefront location and posted on our Instagram page. Many of our patients have learned about services through word of mouth.

Q. Do you partner with local health systems, primary care providers, health clinics or other programs?

We partner closely with several community-based organizations and health clinics. Referrals are often placed to two federally qualified health centers (FQHCs) in New Haven. All referrals to the CHCV MIP program come from a local FQHC. Additionally, we refer to behavioral health services, dental services, and other specialty services as needed.

In the summer months, the CHCV services partner with Power in a Shower, which provides showers for individuals experiencing homelessness. We also collaborate often among our non-profit peers, such as the Community Alliance for Research & Engagement, Junta for Progressive Action, Downtown Evening Soup Kitchen,  and Integrated Refugee & Immigrant Services. These non-profit connections allow for a clear “window” into the needs of the community. Without the added bureaucracy that often accompanies larger entities, our non-profit peers can facilitate timely conversations around community needs, allowing dynamic responses from entities such as the CHCV and MIP.

The CHCV and MIP serve as vehicles for Yale Medical and Nursing students to see first-hand the challenges to healthcare access experienced by many New Haven community members. Student precepting allows the CHCV and MIP teams to engage the health professions schools in community-based healthcare.

Q. How might this program evolve? What new technology or strategies would you like to employ in the future?

The CHCV continues to represent an intersection of community-based healthcare, harm reduction, and clinical innovation. In the face of New Haven’s profound opioid overdose epidemic, the CHCV (and our brick-and-mortar-based office) have begun using a Fourier-transform infrared spectroscopy (FTIR) machine, which provides a novel mechanism for identifying and tracking harmful adulterants in the drug supply. We combine FTIR testing with real-time delivery of results to our clients and community response teams. Results from testing are accompanied by discussions surrounding safer use and other harm reduction messaging.

Additionally, our MIP team has begun providing dyad-focused care for pregnant and postpartum women (and their children) in SUD residential treatment through Connecticut’s largest provider of addiction treatment services. From the program's inception in January 2022 to March 2023, the MIP completed a total of 157 visits (35 individual moms and 27 individual children). Women living in residence have access to MIP services throughout their 3-8 month stay, and many use the services multiple times for follow-up and personalized care coordination.

The expansion of CHCV and MIP services demonstrates the dynamic nature and nimble response of mobile healthcare. Our vans have flexed to respond to pressing community issues like the COVID-19 epidemic, providing vaccines, hand sanitizer and masks, as well as providing basic primary care, Narcan, and now specific FTIR testing and drug supply alerts.

Q. What is the one thing about this program, good or bad, that has really surprised you? Something you didn't expect to see or experience, an unusual case or treatment, a challenge or barrier you didn't expect to face or didn't expect to be so tough, etc.

The constant battle for funding.

Agile Orthopedics

Agile Orthopedics, Denver, Colorado.

Q. Describe your program, why it's different or innovative, who it serves, how many care providers it features, and how this is improving healthcare access and/or clinical outcomes.

Agile Orthopedics provides in-place amputee services including prosthetic limbs through the use of intentionally designed mobile clinics. This care model is unique in that it addresses the intersection of physical disability and social determinants of health. People dealing with amputation and in need of prosthetic services are often limited in their ability to make it to clinic appointments due to transportation and financial constraints. By providing in-place service, these barriers are eliminated, and access to these services is significantly improved.

The population served is anyone in need of these services, but over time the alignment between our service model and the patient population as a whole has become focused on the underserved. The outcomes we track and have seen are increased speed between amputation and ambulation, which in turn leads to overall improvements in physical health. We are also studying how our intervention affects hospital readmission rates. We suspect that our in-place model, which also includes case management, reduces hospital readmissions following amputation surgery.

Q. What kind of technology do you use?

Mobile healthcare is all about trial and error and continuous improvement. After a bit of experimentation, we landed on a system of adjustable modular prosthetic components designed in Iceland that provide an amazing amount of versatility and options for assembling and fitting prosthetic limbs in the field. We also use 3D scanning to capture detailed dimensions of patients’ limbs and changes over time. We are always improving and expanding the capabilities of our specialized mobile clinics that house all the equipment and machinery required for comprehensive on-site prosthetic services.

Q. Why did you choose to launch a mobile program? How does this work better than a brick-and-mortar clinic or virtual program?

After many years of leading traditional outpatient programs, it became clear that the no-show rates were very high, sometimes up to 50%. I took a deep dive into this issue and found that patients are faced with overwhelming barriers to engaging in the requirements of traditional clinics. Social determinants of health, like access to healthcare and economic stability, combined with the real challenges of physical disabilities make it impossible for many amputees to be provided with the prosthetic management they need. Using mobile services for those in need surfaced as a viable solution to remove barriers and improve access and equity to these services.

Q. What are the biggest challenges this program faces?

Recruiting practitioners who are suited for and truly understand mobile healthcare has been a challenge. The requirements to be highly organized, incredibly creative and improvisational, and to operate in variable, unpredictable situations, take a special person with unique perspective.

Q. How is this program supported so that it is sustainable?

We partner with hospitals, physicians, and surgeons to promote patient choice of providers and raise awareness that mobile care is an option. The differentiation and truly patient-centric approach has gained traction over the last several years, which has led to the sustainability of the organization.

Q. How are patients charged for healthcare services? Do you work with payers?

All services we provide are covered through Medicaid, Medicare, and private insurance carriers. We also work with a non-profit organization in order to cover those without insurance or resources.

Q. How do you let people know when and where you'll be located? How do you market your services?

We generally market our services directly to hospitals, physicians, and physical therapists who get the word out about our services. We also attend events and support other organizations that serve the underserved.

Q. Do you partner with local health systems, primary care providers, health clinics, or other programs?

Yes, partnerships are critical, as amputee services require a team approach.

Q. How might this program evolve? What new technology or strategies would you like to employ in the future?

In an effort to provide more community-based amputee care, we have begun to offer amputee-specific physical therapy. This has improved the comprehensive approach to our services. In the future, we plan to add occupational therapy and case management, as these are needs that are predictable within the population we serve.

Q. What is the one thing about this program, good or bad, that has really surprised you? Something you didn't expect to see or experience, an unusual case or treatment, a challenge or barrier you didn't expect to face or didn't expect to be so tough, etc.

I’ve been surprised by how our services have aligned with specific populations over time. So much of our identity has changed since the initial design and marketing of the organization toward anyone in need of prosthetic services who might require or just prefer the mobile model. We have come to align closely with certain underserved communities, like the unhoused, and those within the state and federal department of corrections systems who particularly need mobile services. This type of alignment has driven innovation in our programs to serve very specific needs of those populations.

The Mobile Cancer Screening Van

The Mobile Cancer Screening Van, operated by the Sidney Kimmel Cancer Center at Jefferson Health, Philadelphia, Pennsylvania.

Q. Describe your program, why it's different or innovative, who it serves, how many care providers it features, and how this is improving healthcare access and/or clinical outcomes.

The Sidney Kimmel Cancer Center (SKCC) Mobile Cancer Screening Van offers multi-cancer screening opportunities tailored to the risk of communities, as well as additional social services to reduce adverse social determinants of health. The van services a seven-county catchment area spanning the Greater Philadelphia region in Pennsylvania and New Jersey. 

The van offers breast, prostate, skin, head and neck, and colorectal cancer screening; cervical cancer screening is being onboarded in 2023. The unit also offers services such as hepatitis B screening and vaccination, connection to primary care, and chronic disease screenings for hypertension and diabetes. Services to reduce adverse social determinants of health have included connection to free Internet and technology (tablet computers) and food pantries, as well as assistance in registering to vote. All screenings and services are offered free of charge. For patients who are uninsured, a fund at SKCC covers the cost of screenings and any diagnostic testing needed. 

Q. What kind of technology do you use?

The mobile screening van is fully equipped with Epic, our health system’s electronic medical record, to record patient screenings and evaluate impact over time. For breast cancer screening, the mobile van is equipped with state-of-the-art 3D tomosynthesis for screening mammography.

Q. Why did you choose to launch a mobile program? How does this work better than a brick-and-mortar clinic or virtual program?

The SKCC launched a mobile cancer screening van as one way to reduce cancer disparities in our catchment area. Cancer incidence and mortality rates are higher in our catchment area than state or national rates and disparities exist within our populations. Philadelphia County, at the heart of our catchment area, has the highest levels of poverty of any large city in the US, and a majority of residents are battling adverse social determinants of health in their everyday lives.

Innovative care delivery models are needed to overcome traditional barriers to care experienced by our residents, such as lack of transportation, lack of time for medical care, and unfamiliarity with preventive care and cancer screening. By bringing healthcare to residents, mobile cancer screening reduces many of the known barriers to care.

Q. What are the biggest challenges this program faces?

Every cancer screening event is held in conjunction with a community partner; therefore, our team is engaging with hundreds of community partners each year. Some community partners, like primary care clinics, are used to hosting clinical events like a screening day, while others, such as church groups, are less familiar with and unaware of the nuances in patient insurance, screening eligibility, and mobile van requirements.

Also, staff turnover at community partners makes consistency in planning sometimes challenging. Patients who are not engaged in the healthcare system often present at the mobile screening van with multiple healthcare needs and require additional care beyond screening. While this is an opportunity to connect patients to other care, it can be taxing at times on the screening van staff.

Q. How is this program supported so that it is sustainable?

The mobile screening van was launched with generous philanthropic donations that continue to sustain key portions of the program. Additional funds from grants, sponsorships, and government funds support the mobile screening van, as does revenue generated from billing insurance for guideline-recommended screenings. The diversity and combination of these funds ensures that the mobile screening van is sustainable well into the future.

Q. How are patients charged for healthcare services? Do you work with payers?

Patients who have health insurance and receive reimbursable cancer screenings are billed for their care.  All payers who have contracts with our healthcare system are accepted on the mobile van. For those who do not have health insurance, screening and follow-up care, if needed, are free of charge.

Q. How do you let people know when and where you'll be located? How do you market your services?

We market our cancer screening events in multiple ways. The community partner often takes the lead on marketing to the individuals in their network; as a trusted community partner, their name and reputation in the community are important for getting the word out. Also, all screening events are posted on our website and anyone can register to attend an event. Lastly, sometimes we do targeted outreach to communities and individuals about particular screening events that need a boost in awareness.

Q. Do you partner with local health systems, primary care providers, health clinics, or other programs?

Yes to all of the above. We also partner with churches, non-profit organizations, public libraries, community colleges, local health departments, employers, and coalitions. We will partner with anyone who wants to bring the mobile cancer screening van to their community.

Q. How might this program evolve? What new technology or strategies would you like to employ in the future?

The program is always evolving to meet the needs of the communities that we serve. For example, we started with a mobile van that only offered breast cancer screening; we are about to onboard our sixth cancer screening exam. There is still more that we can do in cancer prevention and control, such as bringing awareness about lung cancer screening to the community, promoting smoking cessation programs, and providing other cancer prevention services, like HPV vaccination. 

We can also do more to combat the adverse social determinants of health of our residents by offering more wrap-around services to meet their needs and better connections to other aspects of healthcare for them and their family members. We are also working to improve the data analysis and evaluation aspect of our program to ensure that we’re offering the highest quality of care in the most culturally sensitive manner possible.

Q. What is the one thing about this program, good or bad, that has really surprised you? Something you didn't expect to see or experience, an unusual case or treatment, a challenge or barrier you didn't expect to face or didn't expect to be so tough, etc.

The demand for the mobile cancer screening van is so much higher than we anticipated. The COVID-19 pandemic caused many people to go without cancer screening for a significant amount of time, coupled with people who are simply disconnected from healthcare for numerous reasons. Communities are looking for ways to bring quality healthcare to their neighborhoods in a way that is convenient and not cost-prohibitive, and mobile cancer screening fills that need.