From pandemic response to population health: One-year analysis shows transformation of Wayne Health’s mobile health units – News from the School of Medicine
A detailed analysis of a mobile health entity created to bring testing to frontline workers with symptoms of COVID-19 found that the model transformed over time, eventually reaching and then caring for vulnerable populations. of Detroit and surrounding communities.
Edward S. Thomas Endowed Professor of Emergency Medicine and Assistant Vice President of Translational Research for Wayne State University Phillip Levy, MD, MPH; and Erin McGlynn, MD, MPH, chief resident of emergency medicine at Wayne State University and Detroit Receiving Hospital, teamed up with several members and residents of WSU’s Department of Emergency Medicine and the Department of Family Medicine and Public Health Sciences, and Wayne Health administrators for writing the study that put the success of Wayne Health mobile units under the microscope for a year.
The result, “From Pandemic Response to Portable Population Health: A Formative Evaluation of Detroit’s Mobile Health Unit Program,” published in the open-access journal PLOS One, concluded that more broad delivery model could be emulated across the United States, particularly where equal access to health care services can be a significant challenge.
“What struck us most about this analysis is that the model challenges the existing paradigm of care and shows that we can reach vulnerable and hard-to-reach members of the community by providing services, using data to inform the process,” says Dr. Levy.
The document describes the work of the group that runs mobile health units — specially equipped vans with medical equipment — in the Detroit metro area.
The team used the US Centers for Disease Control and Prevention framework for evaluating public health programs. Their primary objective was to determine the success of processes that have been implemented to improve health equity by increasing access to hard-to-reach populations in areas of heightened social vulnerability. They looked at whether additional screening identified patients at high risk for poor health, and whether patients sought and received help with referrals to social services.
The program began as a rapidly deployed drive-thru SARS-CoV-2 testing clinic that was housed in temporary canopied tent shelters at two fixed locations; one in Detroit and the other in Dearborn, Michigan during the first wave of the pandemic. As the local health department established its own large-scale testing site, the team focused on patients in socially vulnerable areas who might lack transportation or be unable to access these services. From April 2020 to March 2021, they evolved and expanded to offer other services, such as lipid testing and blood pressure measurement.
“We were also able to help people connect to services such as food resources and other health resources. Also, there has been an emphasis on data collection, both on COVID cases and other data that we have started to collect,” said Dr. McGlynn, the study’s corresponding author. .
The data was mapped across Detroit to show hotspots or areas of concentrated cases with the goal of tracking other health metrics like blood pressure as well.
“Eventually, when vaccines became available, we were able to use the mobile health units to deliver vaccines to Detroit-area communities,” Dr. McGlynn said. “The work is important to address gaps in health care access created by the COVID pandemic as well as pre-existing disparities in metro Detroit. Not only do we aim to connect people to needed health resources during this pandemic, but we also hope to lay the foundation for future work like this in Detroit by collecting and mapping health data.
Detroit’s Mobile Health Unit program reached 32,523 people from March 20, 2020 through March 24, 2021. The proportion of patients who resided in communities with the Centers for Disease Control and Prevention Social Vulnerability Index ranking Top quartile diseases increased by 25% during localization. SARS-CoV-2 “drive-through” testing from day one of rollout to April 13, 2020, at 27% after pivoting to a mobile platform through August 31, 2020.
Adopting a data-driven rollout strategy yielded even better results: 41% of patients who sought Wayne Health mobile services from September 1, 2020 to March 24, 2021 lived in vulnerable communities. Since October 1, 2021, 1,837 people have been referred to social services and, as of March 14, 2021, 4,603 have received at least one dose of the COVID-19 vaccine.
The scientists concluded that the deployment to at-risk communities also created an opportunity to collect information on the deficits in health and social services that enabled them to meet those same needs.
The program is funded by the Michigan Department of Health and Human Services through 2024, with additional support from philanthropy and fee-for-service activities.