A Digitally Capable Mobile Health Clinic to Improve Rural Health Care in America: A Pilot Quality Improvement Study

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: COVID-19, coronavirus disease 2019; MCHS, Mayo Clinic Health System; MHC, mobile health clinic; SEMN, Southeast Minnesota; SWMN, Southwest Minnesota.

Figure 1

Guiding principles and considerations for virtual community care at Mayo Clinic Health System (MCHS).

Figure 2

Mobile health clinic (MHC) development and implementation framework. The framework depicts the events used to design and implement the MHC quality improvement intervention.

Figure 3

Exterior illustration and floor plan schematic of the mobile health clinic.

Figure 4

Map of the mobile health clinic (MHC) pilot sites. A, The 4 Mayo Clinic Health System regions (Southeast Minnesota, Southwest Minnesota, Northwest Wisconsin, and Southwest Wisconsin) are outlined in blue, and the MHC pilot sites (Kenyon, Blooming Prairie, Sherburn, and Butterfield, Minnesota) are indicated in red. Additional MHC stops are indicated in black. B, Map of the home zip code regions of the patients seen in the MHC during the pilot period. The numbers of patients from each home zip code are also indicated. The zip code regions of the MHC pilot sites are circled in red. IA, Iowa; MN, Minnesota; WI, Wisconsin. Used with permission of Mayo Foundation for Medical Education and Research.