Iqbal Asif, Anil Gokhan, Bhandari Pawan, Crockett Eric D, Hanson Victoria M, Pendse Bhushan S, Eckdahl Jonathan S, Horn Jennifer L
Department of Mayo Clinic Health System Administration, Rochester, MN.
Regional Chair of Clinical Practice, Mayo Clinic Health System-Southwest Minnesota region, Mankato, MN.
Mayo Clin Proc Innov Qual Outcomes. 2022 Sep 22;6(5):475-483. doi: 10.1016/j.mayocpiqo.2022.08.002. eCollection 2022 Oct.
To address the problem of limited health care access for patients in rural southern Minnesota, a digitally capable mobile health clinic (MHC) quality improvement initiative was launched in a rural community-based health system.
This project was designed and implemented according to our institutional strategic plan, guiding principles for virtual community care, and existing approved standards of care. A quality improvement development and pilot implementation framework was rapidly developed using Agile methodology.
The resulting technology and equipment selection, overall clinic design, vehicle vendor selection, clinical schedule and workflows, staffing model, equipment and technology selection, and testing were achieved in 12 months. The pilot site communities were chosen on the basis of size, interest, and lack of existing access. Four underserved rural communities now have access to telehealth consultations, laboratory testing, and in-person primary care examinations. By April 30, 2022, the MHC had provided 1498 patient appointments while maintaining our standards of care. Newly established broadband internet access for these communities and their residents was a valuable secondary outcome.
By designing and implementing an MHC quality improvement intervention that provides both in-person and advanced telehealth options for patients in rural communities, our institution rapidly provided a potential solution for the rural health care crisis. The MHC not only replaces traditional brick-and-mortar facilities but also expands service offerings and access to technology for rural communities and the people who live and work in them.
为解决明尼苏达州南部农村地区患者获得医疗服务受限的问题,在一个以农村社区为基础的卫生系统中启动了一项具备数字能力的移动健康诊所(MHC)质量改进计划。
该项目根据我们机构的战略计划、虚拟社区护理指导原则和现有的批准护理标准进行设计和实施。使用敏捷方法快速制定了质量改进开发和试点实施框架。
在12个月内完成了技术和设备选择、诊所整体设计、车辆供应商选择、临床日程安排和工作流程、人员配备模式、设备和技术选择以及测试。试点社区根据规模、兴趣和缺乏现有医疗服务的情况进行选择。四个服务不足的农村社区现在可以获得远程医疗咨询、实验室检测和面对面的初级保健检查。到2022年4月30日,MHC已提供1498次患者预约,同时维持我们的护理标准。为这些社区及其居民新建立的宽带互联网接入是一个有价值的次要成果。
通过设计和实施一项为农村社区患者提供面对面和先进远程医疗选择的MHC质量改进干预措施,我们机构迅速为农村医疗危机提供了一个潜在解决方案。MHC不仅取代了传统的实体设施,还扩大了农村社区以及在其中生活和工作的人们的服务范围和技术获取途径。