At the University of Miami’s Miller School of Medicine, mobile clinics serve a special group: children. What started as a disaster response initiative after Hurricane Andrew in 1992 is now a dedicated pediatrics program, housed in a 40-foot bus that delivers care to about 3,000 patients annually.
“Many come in and have never seen a dentist, haven’t seen a doctor for years, certainly never had access to specialty care,” says Dr. Lisa Gwynn, medical director of the University of Miami’s Pediatric Mobile Clinic. “We spend a lot of time connecting those kids to as many resources as we possibly can.”
Providing Specialty Care via Telemedicine
Like most mobile clinics, Miami’s program serves low-income people whose access to care is constrained by a lack of insurance, transportation and paid sick leave. In Miami-Dade County, that includes diverse immigrant communities from Little Haiti to Doral, home to a large Venezuelan population. Residents can find the mobile clinic stationed at a school, church or community center.
Technology has become increasingly important to mobile operations, streamlining workflows and making it easier for providers to connect patients with resources. For the Pediatric Mobile Clinic, acquiring a secure internet connection and moving to electronic health records was a game changer, Gwynn says.
That provided a foundation for the clinic’s next big initiative: telemedicine. A provider on the bus uses a telemedicine kit — including a laptop, software, USB plug-ins for digital stethoscopes and electrocardiogram machines, and videoconferencing — to connect patients with remote providers.
“Our biggest accomplishment was in cardiology, because the cardiologist could actually see the EKG tracing right there on her screen, and she could hear the heart sounds,” Gwynn says. “These are patients who would never have had an opportunity to have that type of care.”
To overcome language barriers, the team uses a videoconferencing application that connects to live translators via iPad devices.