Proactively Connecting Residents in Underserved and Low Socioeconomic Status Communities with "Virtual Hospital" Telehealth Access in Response to the COVID-19 Pandemic

Abstract

This report from the field describes the uptake of a telemedicine outreach model among residents in under-resourced urban settings as a proactive response to the COVID-19 pandemic. We describe the methods and uptake of our telehealth virtual hospital program and implications for practice.

A qualitative assessment of provider satisfaction and experiences with a COVID-19 community mobile health clinic outreach model in underserved Baltimore neighborhoods

“… 1 New care models are needed that can remove long-standing barriers to accessing health care and reduce the risk of disease transmission among individuals who are more vulnerable to COVID-19 complications. 5 Amid the current COVID-19 pandemic, community mobile health clinics (CMHC) have emerged as an efficient method for rapidly expanding high quality health services to medically underserved communities. 1 Historically, mobile clinics have been used to reach marginalized communities, including people who are homeless, people who inject drugs, seasonal farmworkers, and people in disaster zones.…”

“… 6 Multiple prior studies have shown the benefits of telehealth services, including an increase of favorable health outcomes, reduced transportation barriers, increased geographical accessibility, and improved patient–provider trust. 5 , 7 CMHC models similarly address these challenges and they can be especially useful in increasing healthcare accessibility in underserved communities and limiting avoidable patient influx into hospitals and emergency departments. 1 , 8 Integration of mobile health delivery models within the current medical system can complement and extend existing structures to increase patient access to efficient and prevention-oriented healthcare services.…”

“…9 A program that implemented the CMHC outreach model within underserved Baltimore neighborhoods found that more than two-thirds of its clients were suffering from multiple chronic diseases and were at high risk for COVID-19-related complications. 5 The CMHC model was used to rapidly expand COVID-19 testing, assess social determinants of health (SDOH), measure participant satisfaction, and provide necessary health services to a marginalized population who otherwise may have gone untested and undiagnosed. 5 …”

“… 5 The CMHC model was used to rapidly expand COVID-19 testing, assess social determinants of health (SDOH), measure participant satisfaction, and provide necessary health services to a marginalized population who otherwise may have gone untested and undiagnosed. 5 …”

“…LifeBridge Health used a COVID-19 Vulnerability Index as a starting point to identify by location where higher-risk inpatient and primary care patients in West Baltimore resided. 5 It determined the zip codes with the largest proportion of vulnerable individuals and then created a mobile clinic pilot program to bring COVID-19 screening and health services to patients where they lived. We staffed a mobile health clinic with a driver, a registered nurse (RN), and a community health worker (CHW) to proactively implement preventative measures against adverse COVID-19 outcomes and bring health care to where the most vulnerable community residents lived.…”