How Do Mobile Health Clinics Impact Patient Access to Care?

November 07, 2018 - Across the country, patients living in health deserts suffer from limited care access and other socioeconomic barriers to healthcare. But mobile health clinics are changing that, driving better patient access to care by pulling right into a patient’s neighborhood.

A mobile health clinic is a basic doctor’s office or exam room located inside a large van, bus, or RV. These vehicle-based clinics belong to health systems or can be their own entities. They travel to medically underserved areas to help connect patients to care when patients would have otherwise gone without care.

Mobile health clinics have become common tools for health systems working to reach their otherwise unreachable patient populations. According to a 2017 report from the Advisory Board, patients report numerous barriers to accessing care:

• Fifty-three percent of low-income adults don’t trust healthcare
• Twenty percent are deterred by high healthcare costs
• Twenty-five percent lack transportation to medical appointments
• Eleven percent lack insurance coverage
• Others report social isolation, racial or economic barriers, or language and cultural barriers

Healthcare organizations designed mobile health clinics to meet these patients’ needs. The clinics show up in a patient’s neighborhood, making the experience a little more trustworthy and convenient, according to Bridget Wicks, a nurse practitioner who works in a mobile health clinic for North Country HealthCare in Flagstaff, Arizona.

“I’m able to see them right there in the parking lot,” Wicks said in a previous interview with mHealthIntelligence.com. “It’s a comforting environment. It’s a secure environment for them, and so they open up to you.”

READ MORE: What Providers Should Know to Improve Patient Access to Healthcare

Research corroborates that anecdote. A 2017 literature review published in the International Journal for Equity in Health noted that mobile health clinics make an unfamiliar healthcare environment more familiar by being located right in a patient’s neighborhood.

“Qualitative research has found that patients value MHCs’ informal setting, familiar environment, convenient location and staff who ‘are easy to talk to,’” the literature review authors explained.

“Because MHCs make the effort to physically drive into communities, community members feel that the clinics are reaching out to care about them, inspiring them to take more charge of their own health.”

Mobile health clinics are making their mark on healthcare, the Advisory Board reported. Currently, there are about 2,000 mobile health clinics on the road. The operational cost of these clinics is $429,000 annually. And with 6.5 million mobile health clinic visits each year, return on investment comes out at about $12 per patient.

Healthcare organizations hosting mobile health clinics aren’t just saving money; they are also making a dent in the most vulnerable, safety-net patient populations, the Advisory Board report added. Sixty percent of the patients visiting mobile health clinics are uninsured, and another 31 percent have public insurance.

Most of these clinics focus on preventive care (45 percent) and primary care (42 percent). Thirty percent of mobile health clinics also provide dental care.

But how effective are mobile health clinics? And how sustainable are they in the current healthcare landscape? Below, PatientEngagementHIT.com discusses the benefits and challenges of mobile health clinics and how they can fit into healthcare organizations’ primary care footprints.

How effective are mobile health clinics?

As the healthcare industry seeks to reduce care disparities, address the social determinants of health, and promote value-based care, mobile health clinics have served to fill in the gaps. These vehicle-based clinics have proven extremely effective at connecting high-risk patients with primary and preventive care.

Data included in the International Journal of Equity in Health literature review showed that mobile health clinics have made it easier for patients to access the appropriate type of care.

Industry experts often look at emergency department utilization rates to understand the overall health of a region. When ED utilization rates are excessive, experts can conclude that there are critical primary care needs in a community.

Research included in the literature review found that visits from a mobile health clinic reduced ED costs and utilization.

In other communities, mobile health clinics have led to lower readmission rates, more symptom-free days, and better patient reports of quality of life.

Mobile health clinics are also good at delivering on value-based care. Because these clinics focus on preventive and primary care, they can detect at-risk individuals and begin health interventions early, increasing the likelihood of recovery and reducing eventual health costs.

“Because mobile clinics can successfully reduce barriers in access to healthcare, MHCs provide more opportunities for underserved populations to screen for various conditions and learn to properly manage their health,” the literature review authors said.

Mobile health clinics can also be effective at improving chronic disease management, the literature review authors explained.

“The challenge of chronic disease management is sustaining adherence to the necessary medications and lifestyle changes, and quantitative evidence from multiple MHCs signify that mobile clinics are effective in helping patients address these challenges,” they wrote.

This is because mobile health clinics come to patients and make it easier for them to engage with their healthcare providers. For example, one study showed that mobile health clinics reduced LDL in high blood pressure patients because patients received more support in self-management and gave patients a regular place for treatment access.

Some studies suggest that patients who visit mobile health clinics can also increase their health literacy, making it easier and more empowering for them to manage their own health. One of the studies included in the literature review found that patients were 78 percent more likely to self-manage their conditions after visiting a mobile health clinic.

What are the challenges of mobile clinics?

Of course, mobile health clinics are not a panacea. While these clinics can be effective at closing care gaps, addressing the social determinants of health, and promoting health equity, they also have some shortcomings, according to one article published in the International Journal of Health System & Disaster Management.

For example, mobile health clinics can drive more fragmented care. Convenient care access is the draw of mobile health clinics. But if a patient’s primary care provider or preferred hospital for when they fall seriously ill is a part of a different health system, data could be stored in siloes.

Mobile health clinics may also encounter difficulties sustaining themselves. The mobile part of the clinic can create some spatial limitations for equipment or number of patients served. It could also be difficult to recruit clinicians to serve inside of these mobile clinics.

Even still, mobile health clinics are filling a healthcare need. Healthcare organizations working to reach previously unreachable patient populations are employing mobile health clinics to help address patient needs.

Organizations considering implementing a mobile health clinic may think about:

• The business goal of the clinic
• Partners and funding sources for the clinic
• Hiring and training of staff; the shifts the staff will work
• Logistical concerns such as hours of operation and locations to visit
• Evaluating impact

The goal to drive health equity and address the social determinants of health is pressing, as more providers understanding that reaching populations that are often left behind will ultimately drive care quality and outcomes for everyone.