Quality: Health on Wheels

To fill in gaps, the March of Dimes has teamed up with local providers such as the Daughters of Charity Health Center, a major provider of community health services in the New Orleans area, and the Coastal Family Health Center in Biloxi, MS, to sponsor and staff four mobile vans that provide prenatal, postnatal, and well-baby care services throughout the area.

With some hospitals closed and public health clinic services recently cut back, the need for care from preconception to postpartum are "particularly strong and will continue to be strong" for these types of services," says Scott Berns, MD, MPH, March of Dimes' senior vice president of chapter programs.

Rosa Bustamante Forest, RN, MPH, the program director for one of the Mom and Baby Mobile Health Centers in New Orleans, notes that Louisiana has been at the bottom of many national report cards for indices such as preterm labor and infant mortality. Working with the mobile facility, which is staffed with two advance practice nurses with extensive maternity experience, they have worked to identify ways to bypass those barriers to care.

One barrier has been language. Since many of their patients are Spanish-speaking and "because we are bilingual, we can offer these women access to quality healthcare," says Bustamante Forest. Also, many of their patients, who are on Medicaid, have the ability to access other points of care, but many of them, because of their culture, appeared leery of going to what she calls "land-based clinics" or hospital-based clinics.

The mobile facility has been able to partner for meeting space with local churches and to provide services in the community to the pregnant women through a group prenatal program called CenteringPregnancy; physical assessments and education are offered and referrals are made to hospitals for high-risk women who require specialized care. "We're seeing repeat patients from last year who are pregnant again, which speaks volumes to the quality of care we offer," she said.

Mobile care plus telemonitoring
Providing care does not necessarily mean that the healthcare providers need to be on-site. Beginning in January, Project HOPE, the humanitarian group, is partnering with UnitedHealth Group's Connected Care program, a new national telehealth network, to sponsor a new mobile clinic that will assist residents in rural New Mexico—especially those with chronic conditions such as diabetes or related conditions such as high blood pressure.

The mobile facility will permit patients to talk to and view physicians, via satellite link, hundreds of miles away. With specially designed equipment such as stethoscopes or thermometers, the providers will be able to instantly monitor their patients' vital signs and record the patient visits with electronic records.

John Howe III, MD, president and chief executive officer of Project HOPE, says the new technology will help Project HOPE to "play a larger role in improving access to quality healthcare" in underserved areas of the country. To promote training and care delivery, Project HOPE will partner with the University of New Mexico Health Sciences Center, Office for Community Health and the New Mexico Department of Health, along with multiple community health centers and other local organizations.

—Janice Simmons