Supporting Mobile Health Clinics
Irwin Redlener and Paul Simon founded the Children’s Health Fund for New York City in 1987. The initial function for the fund was to provide pediatric care for homeless kids in New York City. The fund expanded its mission to providing comprehensive health care to the most medically underserved children in 17 states across the country. The organization uses RV-size medical clinics to deliver medical equipment and services to the locations in dire need of such services such as homeless shelters, and rural areas.
The provision of high quality primary medical care is fraught with several unique challenges. Compliance with regulatory standards such as the PC locations’ regulations set forth by JCAHO, and the HIPAA laws is a major challenge for the mobile clinics. In addition, it is often difficult to design an environment that can support the standardized physical office and clinical processes when the medical team is working from an RV.
Another challenge the organization faces is providing a mobile unit with the capability of operating in different sites, each having its own specific environmental factors. However, the biggest challenge that the organization faces is ensuring that every mobile clinic has the proper computer and communications technologies installed. Such technologies need to be dependable and reliable as well as provide off-site access to technical support when in remote locations.
For this situation to occur, network availability and reliability is paramount. The technologies also need to guarantee data security, should be easy to use without the need for on-site support, and they should also be cheap to operate and deploy. Unfortunately, network availability and reliability is a major challenge because the mobile clinics are often deployed in areas that do not provide reliable access to data and voice networks.
To address the challenges surrounding connectivity needs, the organization has tried several networking solutions. For instance, the company equipped some of its MMCs with rooftop satellite antenna systems. The systems proved to be mechanically unreliable because they alienated the users from utilizing the technology perhaps because they were prone to mechanical system failures. They were also structurally problematic for the mobile clinics owing to their weight.
Other technological solutions that the company has adopted to deal with connectivity issues include cellular wireless networks, and the delayed broadband-wired access. The cellular wireless networks are only suitable for MMC communications that are not mission critical. The reason for this is the fact that most cellular coverage and wireless networks are primarily designed for consumer levels. Thus, the technology is prone to interruptions, loss of signal, and overloading.
The broadband-wired access is an alternative for the cellular wireless networks when it comes to mission critical communications. In this type of system, the patient records, digital images, and medical referrals are stored in the mobile clinic’s server until the Internet access is available and reliable.
The Asynchronous multi-master database replication has also been used by the MMCs in the absence of high speed networking solutions. The AMMR allows for the transfer of patient data from the mobile clinic to the organization’s headquarters. The main problem with this system is that it requires the MMC to be at a physical proximity to the offices in the Bronx.
The need for mobile clinics that provide primary medical care to high-risk individuals is increasing in the region as evidenced by the Haiti earthquake devastation. There are newer and affordable network communication solutions that the company can adopt. Such technologies are not mainstream but they have proven to be more effective and affordable compared to the more familiar technologies.
The HITECH stimulus and the Meaningful Use will definitely lead to more effective software integration solutions because they will promote productive research into the area. Furthermore, the adoption of software in physician offices will not hinder the retention of staff. Staff members are required to monitor the software as well as provide cognitive techniques to the handling of the data. Finally, the mobile medical clinic model will always be needed as long as there are people in the community who are medically underserved owing to their poverty status.