Bayhealth—a nonprofit health system with more than 4,000 employees and 400 physicians in Central and Southern Delaware—was looking for a way to bring care to the underserved and to those with mobility issues. Their solution: Turn a 38-foot recreational vehicle (RV) into a mobile health clinic with a private exam room and two screening booths.
Medical literature has shown that if you are able to go to communities, you'll improve their health, according to Parvathi Somasundaram, MD, MPH, an occupational medicine physician and medical director of Bayhealth Occupational Medicine and Walk-in. She is a member of the mobile health clinic program at Bayhealth, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Care on the go can also save a life.
Dr. Somasundaram recalls when mobile health clinic staff acted quickly on a patient with severe high blood pressure who was complaining of dizziness. “I know they most likely saved his life and were able to intervene before we needed to do CPR at the hospital. He was so grateful,” said Dr. Somasundaram.
The mobile health clinic travels throughout Delaware communities, offering physical exams, health screenings, vaccinations, lab work and echocardiograms. Certified medical assistants, nurses, physicians and phlebotomists work as a team to provide care.
“It’s important for us to understand there are barriers to care, understand what those are, look at those individual needs and then provide services to meet those needs,” she said.
In an AMA interview, Dr. Somasundaram talked about the Bayhealth mobile health unit’s beginnings, the communities it serves and how it addresses gaps in care by bringing the clinic to where people live.
Getting upgrades
The concept of a “mobile” unit isn’t new to Bayhealth. “We’ve had a mobile RV going back 25 years,” said Dr. Somasundaram. But the old unit had limited capability.
“There was not much room on the unit, we had to use facilities onsite,” such as a church or community center, and administer shots inside the building, she said.
That’s why, in 2023, Bayhealth unveiled a new mobile health clinic with a renewed purpose to bring health and wellness to the community. From an educational standpoint, this meant health information outreach, providing a link between the community and health care while offering screening, testing and other medical services on the mobile health clinic.
“This new mobile unit is a big upgrade. It can go anywhere. We don't need additional space—all services can be performed in the unit. It's a complete medical office on wheels,” said Dr. Somasundaram.
In addition to an exam room, it also has EHR capabilities, “which is great for lab, charting, referral and care integration with a patient's primary care provider and any specialists,” she added.
Reaching the underserved
Among the Delaware patient groups that have been traditionally underserved by limited access to health care are the state’s rural, Amish, Hispanic and Asian communities. There is also a longstanding Black community.
Notably, “Harriet Tubman and her journey through Philadelphia went through this area. It’s a very historical area and there's been a lot of issues with transport, trust and fear of services,” said Dr. Somasundaram.
But the trust and fear of services did not come from nowhere. It came from racism, segregation and other structural forms of inequities. In turn, many turn to the emergency department with illnesses.
Patients from these areas often present in the emergency department with heart disease, signs of untreated blood pressure and diabetes, so “there’s really an opportunity to keep reaching out to those communities, to break down barriers, show a face, answer questions,” she said.
Public health means meeting someone where they are, introducing yourself and then telling them, “I'll be there in the clinic when you come in,” Dr. Somasundaram added.
Targeting services
Through community needs assessments, Bayhealth’s community outreach team members can identify where the needs are for the mobile unit, and target services.
During the pandemic, the mobile health clinic visited a local church and an assisted living facility to provide vaccines and education outreach. Last fall, the mobile health clinic set up at a local corporate center to offer flu shots.
The mobile health clinic also travels to local companies, offering services such as physicals, audiograms, spirometry and laboratory work to employees.
“They may not have time to come to us, so we go to them,” said Dr. Somasundaram, noting she and her staff often provide physicals and vision testing to employees at law enforcement agencies, who may need these services to meet state regulatory or legal requirements.
Such services have been in high demand, she noted, and employees are happy because they don’t have to travel far for care. They’re back to work quickly.
Buy-in from the community is very important. For example, the Hispanic community has been very supportive of the mobile service, said Dr. Somasundaram. “Being invited in builds trust. During COVID, the local church requested that we come to them. We have to be flexible and then meet people where they are.”
Health systems interested in establishing a mobile unit should think outside the box and be bold. Make it fun, Dr. Somasundaram advised.
Look at the needs in your community and then tailor your services to the needs of your patients, she said. “Think about being big and really innovative because sometimes you have to be flexible,” to reach those patients with fear and trust issues.
