Nancy Elizabeth Oriol*, Harvard Medical School, Boston, United States Caterina Hill, Harvard Medical School, Boston, United States Anthony Vavasis, Callen-Lorde Community Health Center, New York, United States Paul Cote, Independent Health Care Consultant, Boston, United States Jennifer Bennet, Mobile Health Map, Boston, United States Darien Delorenzo, National Mobile Clinics Network, San Fransisco, United States John Brownstein*, Children's Hospital, Boston, United States Track: Practice Presentation Topic: Health disparities Presentation Type: Oral presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: Auditorium Date: 2012-09-16 11:45 AM – 12:30 PM Last modified: 2012-09-12

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Background: As outlined in the Affordable Care Act and Healthy People 2020, new cost-effective interventions are needed to create healthy communities and reduce health disparities across the U.S.. Nationally, there are an estimated 2,000 mobile health clinics providing services to under-served communities. Many of these services include those outlined in the National Prevention Strategy and the National Partnership for Action to End Health Disparities. However, hitherto the sector lacked a means to come together as a community and evaluate its impact.
Objective: to develop a mobile clinic research community to demonstrate the value of the mobile clinic sector and to evaluate its role in addressing health disparities and healthcare costs.
Methods: HealthMap, Harvard Medical School and the trade organization Mobile Health Clinic Association came together to build MobileHealthMap.org, a website where mobile clinics can place themselves geographically on a national map. Programs are provided an interface to input aggregate data to calculate the impact of the service in terms of providing services to communities with health disparities and saving health care costs through avoided emergency department visits and quality life years saved.
Results:
Demonstrating impact: MobileHealthMap.org has brought together mobile clinics across the country as a sector. For the first time there are estimates of the sector’s scope and impact. To date, 470 mobile clinics from 49 states have joined the research community, serving more than 1 million individuals annually. It is estimated that this is ¼ of the sector. Based on data inputted into MobileHealthMap.org, mobile clinics were able to demonstrate that the sector serves communities with the highest burden of preventable disease and poorest access to healthcare. Of the clients served 68% had no insurance, 28% public insurance, 5% private insurance, 45% identified as Latino and 34% as non-white. Mobile clinics served men (43%) as well as women (58%) and rural (42%) as well as urban areas (58%) (n=48). The sector provides a range of services including primary care (40%), prevention (39%) dental (30%), mammography (17%), specialty (13%) and mental health (7%) (n=344). The return on investment of these services is $21:$1 in terms of emergency department visits avoided and quality life years saved (n=10).
Challenges in building the Research Community: there is no central repository of mobile clinics so the representativeness of the sample is difficult to establish. Many clinics lack the capacity to collect or retrieve data so have not been able to enter information on services provided or the demographic characteristics of their clients. The Return on Investment calculation is limited to those with sufficient data, as analyzed by the National Commission for Prevention Priorities. It does not yet cover several important interventions such dental services.
Building sustainability: In 2012 the Department for Health and Human Services provided support to launch this into a Collaborative Research Network.
Conclusions
This website has brought together mobile clinics into a community that is able to demonstrate its role in the National efforts to reduce health disparities and save healthcare costs.